=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497947881
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LIZA KIT JANE CHAU RN, CPNP, ANP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/09/2007
-----------------------------------------------------
Last Update Date | 09/26/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 317 E 34TH ST STE 1002 DIV OF PEDIATRIC NEUROSURGERY - NYU LANGONE MEDICAL CEN
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10016-4974
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-263-6419
-----------------------------------------------------
Fax | 212-263-8173
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 400 E MAIN ST STE 106
-----------------------------------------------------
City | MOUNT KISCO
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10549-3417
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-362-6280
-----------------------------------------------------
Fax | 146-666-1401
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | 307451
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------