Healthcare Provider Details

I. General information

NPI: 1043897333
Provider Name (Legal Business Name): BETHINA LIU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST STARR 5
NEW YORK NY
10065
US

IV. Provider business mailing address

505 E 70TH ST
NEW YORK NY
10021-4872
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-4071
  • Fax:
Mailing address:
  • Phone: 212-746-2900
  • Fax: 212-746-4610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number319646
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: