Healthcare Provider Details

I. General information

NPI: 1154437267
Provider Name (Legal Business Name): REN Y LIU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 09/20/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 E RIDGEWOOD AVE
PARAMUS NJ
07652-4142
US

IV. Provider business mailing address

5 UNIVERSITY PL
GREAT NECK NY
11020-1438
US

V. Phone/Fax

Practice location:
  • Phone: 973-517-2000
  • Fax:
Mailing address:
  • Phone: 973-517-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA08030800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number243234
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: