MEDICARE: LORA LIU

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	207VG0400X	Gynecology Physician	268428	NY

General Provider Information

NPI Number	:	1730470865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORA LIU

Provider Business Mailing Address
First Line	:	4 S ORANGE AVE # 254
Second Line	:
City	:	SOUTH ORANGE
State	:	NJ
Zip	:	07079-1702
Country	:	US
Telephone Number	:	212-381-0796
Fax Number	:	646-248-5182

Provider Business Practice Location Address
First Line	:	377 JERSEY AVE STE 220
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-4396
Country	:	US
Telephone Number	:	212-381-0796
Fax Number	:	646-248-5182

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2011
Last Update Date	:	11/03/2023

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Directions to “ LORA LIU ” Practice Location

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