Healthcare Provider Details

I. General information

NPI: 1588396543
Provider Name (Legal Business Name): CATHERINE LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2022
Last Update Date: 06/28/2022
Certification Date: 06/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 AVENUE OF THE AMERICAS STE 205
NEW YORK NY
10001-3514
US

IV. Provider business mailing address

25 MONTROSE AVE APT 502
BROOKLYN NY
11206-1981
US

V. Phone/Fax

Practice location:
  • Phone: 211-967-4166
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number009542
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: