Healthcare Provider Details

I. General information

NPI: 1912959644
Provider Name (Legal Business Name): MING-KONG LIU M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 N WASHINGTON AVE
BERGENFIELD NJ
07621-1742
US

IV. Provider business mailing address

155 N WASHINGTON AVE
BERGENFIELD NJ
07621-1742
US

V. Phone/Fax

Practice location:
  • Phone: 201-501-0082
  • Fax: 201-501-8859
Mailing address:
  • Phone: 201-501-0082
  • Fax: 201-501-8859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number25MA06483400
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA06483400
License Number StateNJ

VIII. Authorized Official

Name: DR. MING-KONG LIU
Title or Position: PRESIDENT
Credential: M.D.
Phone: 201-501-0082