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General NPI Number Information
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NPI Number | 1538488127
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Entity Type | Organization
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Legal Business Name | FRONTIER MEDICAL SERVICES PLLC
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Dates
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Enumeration Date | 05/22/2010
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 210 CANAL ST SUITE 601
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City | NEW YORK
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State | NY
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Zip | 10013-4155
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Country | US
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Telephone | 201-339-1700
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Fax | 201-339-6972
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Provider Business Mailing Address
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Address Line | PO BOX 79
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City | BAYONNE
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State | NJ
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Zip | 07002-0079
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Country | US
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Telephone | 201-339-1700
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Fax | 201-339-6972
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Authorized Official
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Title or Position | GENERAL PARTNER
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Name | REN LIU
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Credential | M.D.
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Telephone | 201-339-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State | NY
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