1437653672 NPI number — HONGDAU PETER LIU MD, PHD

Table of content: HONGDAU PETER LIU MD, PHD (NPI 1437653672)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437653672 NPI number — HONGDAU PETER LIU MD, PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LIU
Provider First Name:
HONGDAU
Provider Middle Name:
PETER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD, PHD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437653672
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/21/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 GUSTAVE L LEVY PL # 1259
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10029-6504
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-241-5972
Provider Business Mailing Address Fax Number:
212-410-0111

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 GUSTAVE L LEVY PL FL 12
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10029-6574
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-241-6500
Provider Business Practice Location Address Fax Number:
212-590-3300
Provider Enumeration Date:
03/21/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)