MEDICARE: JIAN Q LIANG DPM P C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0131X	Foot Surgery Podiatrist	N005666	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194005611
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JIAN Q LIANG DPM P C

Provider Business Mailing Address
First Line	:	139 CENTRE ST STE 211
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10013-4553
Country	:	US
Telephone Number	:	212-619-2539
Fax Number	:	212-871-0020

Provider Business Practice Location Address
First Line	:	139 CENTRE ST STE 211
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10013-4553
Country	:	US
Telephone Number	:	212-619-2539
Fax Number	:	212-871-0020

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JIAN Q LIANG
Credential	:	D.P.M.
Telephone Number	:	212-619-2539

Provider Enumeration Date	:	08/29/2011
Last Update Date	:	08/28/2012

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