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General NPI Number Information
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NPI Number | 1174983084
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Entity Type | Organization
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Legal Business Name | DIMENSION HEALTH LLC
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Dates
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Enumeration Date | 03/04/2016
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Last Update Date | 03/04/2016
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Provider Practice Location Address
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Address Line | 175 FAIRFIELD AVE STE 4A
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City | WEST CALDWELL
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State | NJ
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Zip | 07006-6415
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Country | US
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Telephone | 973-975-0298
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Fax |
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Provider Business Mailing Address
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Address Line | 175 FAIRFIELD AVE STE 4A
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City | WEST CALDWELL
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State | NJ
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Zip | 07006-6415
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. YING LIU
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Credential | MD
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Telephone | 973-975-0298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA09291800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 25MA09291800
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License Number State | NJ
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