Healthcare Provider Details

I. General information

NPI: 1467679944
Provider Name (Legal Business Name): EUGENE J LIU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 CORPORATE WAY STE 2M
VALLEY COTTAGE NY
10989-2027
US

IV. Provider business mailing address

1075 CENTRAL PARK AVE STE 409
SCARSDALE NY
10583-3232
US

V. Phone/Fax

Practice location:
  • Phone: 718-362-1411
  • Fax: 718-362-1651
Mailing address:
  • Phone: 914-693-1050
  • Fax: 914-693-1050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number221503
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: