Healthcare Provider Details

I. General information

NPI: 1477470912
Provider Name (Legal Business Name): JOCELYN LIU OD
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 W 42ND ST
NEW YORK NY
10036-8005
US

IV. Provider business mailing address

33 W 42ND ST
NEW YORK NY
10036-8005
US

V. Phone/Fax

Practice location:
  • Phone: 212-938-4000
  • Fax:
Mailing address:
  • Phone: 212-938-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number011410
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: