MEDICARE: UNIMED CENTER

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	2083X0100X	Occupational Medicine Physician	25MA09132400	NJ
2	133NN1002X	Nutrition Education Nutritionist	006694-1	NY
3	207QB0002X	Obesity Medicine (Family Medicine) Physician	25MA07506100	NJ
4	207R00000X	Internal Medicine Physician	25MA07506100	NJ

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	:	1295900587
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIMED CENTER

Provider Business Mailing Address
First Line	:	190 STATE ROUTE 18 STE 202
Second Line	:
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-1407
Country	:	US
Telephone Number	:	732-828-9988
Fax Number	:	732-828-1010

Provider Business Practice Location Address
First Line	:	190 STATE ROUTE 18 STE 202
Second Line	:
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-1407
Country	:	US
Telephone Number	:	732-828-9988
Fax Number	:	732-828-1010

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JENNY H.Y. LIU
Credential	:	M.D., M.S.
Telephone Number	:	732-828-9988

Provider Enumeration Date	:	04/28/2008
Last Update Date	:	08/15/2013

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Directions to “UNIMED CENTER ” Practice Location

Language	Start Address	Practice Location

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