Healthcare Provider Details

I. General information

NPI: 1124047592
Provider Name (Legal Business Name): YUYAN LIU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 01/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 NEW BRUNSWICK AVE
PERTH AMBOY NJ
08861-3654
US

IV. Provider business mailing address

54 KELLY WAY
MONMOUTH JUNCTION NJ
08852-2684
US

V. Phone/Fax

Practice location:
  • Phone: 732-324-5075
  • Fax:
Mailing address:
  • Phone: 732-438-6701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA07251500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: