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General NPI Number Information
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NPI Number | 1629043443
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Entity Type | Individual
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Provider Name | PUI-KAN LIAO MB BS
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Gender | Female
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 02/13/2016
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Provider Practice Location Address
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Address Line | 3 HIGH OAKS DR
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City | BERKELEY HEIGHTS
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State | NJ
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Zip | 07922-1621
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Country | US
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Telephone | 908-656-2827
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Fax | 908-790-9551
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Provider Business Mailing Address
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Address Line | PO BOX 61
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City | BERKELEY HEIGHTS
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State | NJ
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Zip | 07922-0061
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Country | US
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Telephone | 908-656-2827
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Fax | 908-790-9551
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 25MA05290500
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License Number State | NJ
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