Provider Demographics
NPI:1033222831
Name:LIANG, WEINING W (MD)
Entity Type:Individual
Prefix:
First Name:WEINING
Middle Name:W
Last Name:LIANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 520112
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11352-0112
Mailing Address - Country:US
Mailing Address - Phone:718-886-1150
Mailing Address - Fax:718-886-1185
Practice Address - Street 1:133 02 41ST AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-886-1150
Practice Address - Fax:718-886-1185
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203586207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01849985Medicaid
G42608Medicare UPIN
NY01849985Medicaid
NY07447Medicare ID - Type Unspecified