Healthcare Provider Details

I. General information

NPI: 1598474991
Provider Name (Legal Business Name): YINING LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2022
Last Update Date: 11/15/2022
Certification Date: 11/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 W 31ST ST FL 5
NEW YORK NY
10001-3596
US

IV. Provider business mailing address

100 COLUMBUS DR APT 2903
JERSEY CITY NJ
07302-5566
US

V. Phone/Fax

Practice location:
  • Phone: 718-802-0666
  • Fax:
Mailing address:
  • Phone: 551-209-6505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: