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General NPI Number Information
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NPI Number | 1639252380
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Entity Type | Organization
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Legal Business Name | J & J MEDICAL CARE PLLC
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 14351 ROOSEVELT AVE SUITE 1B
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City | FLUSHING
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State | NY
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Zip | 11354-6106
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Country | US
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Telephone | 718-359-5603
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Fax | 718-359-5610
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Provider Business Mailing Address
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Address Line | 7523 195TH ST
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City | FRESH MEADOWS
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State | NY
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Zip | 11366-1841
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Country | US
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Telephone | 718-359-5603
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Fax | 718-359-5610
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JASON SHIXIE LIU
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Credential | MD
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Telephone | 718-359-5603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 216399
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License Number State | NY
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