Healthcare Provider Details

I. General information

NPI: 1518064518
Provider Name (Legal Business Name): JIANFEI LUCY LIU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON RD DEPARTMENT OF RADIOLOGY
NEWARK DE
19718-2200
US

IV. Provider business mailing address

4755 OGLETOWN STANTON RD DEPARTMENT OF RADIOLOGY
NEWARK DE
19718-2200
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-1806
  • Fax: 302-733-1808
Mailing address:
  • Phone: 302-733-1806
  • Fax: 302-733-1808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2006-00630
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberC1-0008754
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: