MEDICARE: JIAN Q LIANG DPM

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	213E00000X	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	:	1225102791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIAN Q LIANG DPM

Provider Business Mailing Address
First Line	:	139 CENTRE ST
Second Line	:	SUITE 211
City	:	NEW YORK
State	:	NY
Zip	:	10013-4552
Country	:	US
Telephone Number	:	212-619-2539
Fax Number	:	212-871-0020

Provider Business Practice Location Address
First Line	:	139 CENTRE STREET
Second Line	:	SUITE 211
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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	11/29/2011

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Directions to “ JIAN Q LIANG DPM” Practice Location

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