Healthcare Provider Details

I. General information

NPI: 1316663792
Provider Name (Legal Business Name): CHINGYIN LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2022
Last Update Date: 10/17/2022
Certification Date: 10/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 E AMES CT
PLAINVIEW NY
11803-2317
US

IV. Provider business mailing address

42 CHESTNUT HL
ROSLYN NY
11576-2824
US

V. Phone/Fax

Practice location:
  • Phone: 516-414-6900
  • Fax:
Mailing address:
  • Phone: 917-774-2101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number421587
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: