Healthcare Provider Details

I. General information

NPI: 1346468261
Provider Name (Legal Business Name): KRISTY CHO LIU NNP, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 10/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST GREENBERG PAVILLION- 6W NICU
NEW YORK NY
10021-4870
US

IV. Provider business mailing address

1921 42ND AVE E APT A
SEATTLE WA
98112-6209
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-0318
  • Fax:
Mailing address:
  • Phone: 917-400-3427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberF350275
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberAP 60406547
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: