Healthcare Provider Details

I. General information

NPI: 1184348351
Provider Name (Legal Business Name): CAROLINE LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2022
Last Update Date: 09/30/2022
Certification Date: 09/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 E 98TH ST UNIT 3F-4
NEW YORK NY
10029-6552
US

IV. Provider business mailing address

50 E 98TH ST UNIT 3F-4
NEW YORK NY
10029-6552
US

V. Phone/Fax

Practice location:
  • Phone: 614-266-2338
  • Fax:
Mailing address:
  • Phone: 614-266-2338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: