Healthcare Provider Details

I. General information

NPI: 1376729293
Provider Name (Legal Business Name): LIANG WEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2008
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PENN PLZ FL 8 OPTUM - UNITED HEALTHCARE
NEW YORK NY
10119-0899
US

IV. Provider business mailing address

1 PENN PLAZA, 8TH FLOOR OPTUM
NEW YORK NY
10119
US

V. Phone/Fax

Practice location:
  • Phone: 212-216-6568
  • Fax: 212-216-6606
Mailing address:
  • Phone: 212-216-6568
  • Fax: 212-216-6606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number340457
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: