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General NPI Number Information
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NPI Number | 1649844671
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Entity Type | Individual
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Provider Name | DR. DI LIU
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Gender | Male
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Dates
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Enumeration Date | 05/14/2021
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Last Update Date | 06/30/2021
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Provider Practice Location Address
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Address Line | 10 NATHAN D PERLMAN PL BERNSTEIN PAVILION
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City | NEW YORK
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State | NY
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Zip | 10003
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Country | US
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Telephone | 212-870-8221
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Fax |
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Provider Business Mailing Address
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Address Line | 10820 71ST AVE APT 9B
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City | FOREST HILLS
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State | NY
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Zip | 11375-4530
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Country | US
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Telephone | 201-355-7951
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Fax |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 024375
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License Number State | NY
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