Healthcare Provider Details

I. General information

NPI: 1609785880
Provider Name (Legal Business Name): CATHERINE LIAO PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 5TH AVE FL 11
NEW YORK NY
10001-8017
US

IV. Provider business mailing address

220 5TH AVE FL 11
NEW YORK NY
10001-8017
US

V. Phone/Fax

Practice location:
  • Phone: 917-410-2064
  • Fax: 347-304-9410
Mailing address:
  • Phone: 917-410-2064
  • Fax: 347-304-9410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number408842
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: