Healthcare Provider Details

I. General information

NPI: 1346582996
Provider Name (Legal Business Name): ROY R LIU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2013
Last Update Date: 04/10/2023
Certification Date: 04/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MOUNT PROSPECT AVE STE 203
CLIFTON NJ
07013-1900
US

IV. Provider business mailing address

50 MOUNT PROSPECT AVE STE 203
CLIFTON NJ
07013-1900
US

V. Phone/Fax

Practice location:
  • Phone: 862-238-8250
  • Fax:
Mailing address:
  • Phone: 862-238-8250
  • Fax: 862-238-8255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number25MA10527600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: