Healthcare Provider Details

I. General information

NPI: 1801231055
Provider Name (Legal Business Name): HAUTIEN PETER LIOU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: PETER LIOU MD

II. Dates (important events)

Enumeration Date: 05/01/2013
Last Update Date: 06/25/2020
Certification Date: 06/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 FORT WASHINGTON AVE # 7GS
NEW YORK NY
10032-3733
US

IV. Provider business mailing address

100 HAVEN AVE APT 27H
NEW YORK NY
10032-2626
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-5970
  • Fax:
Mailing address:
  • Phone: 212-305-5970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number287867
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: