Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 018706 | NY |
NPI | 1033427703 |
---|---|
Provider Name | Tina Liu |
First Address | Brooklyn, NY 11224-4629 |
Second Address | Brooklyn, NY 11224-4629 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2010 |
Last Update Date | 15/05/2016 |