Provider Demographics
NPI:1114256641
Name:ABC PSYCHIATRIC CONSULTANT LLC
Entity Type:Organization
Organization Name:ABC PSYCHIATRIC CONSULTANT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:QINYUE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-222-1532
Mailing Address - Street 1:115 PARLIN LN
Mailing Address - Street 2:
Mailing Address - City:WATCHUNG
Mailing Address - State:NJ
Mailing Address - Zip Code:07069-5400
Mailing Address - Country:US
Mailing Address - Phone:908-222-1532
Mailing Address - Fax:908-222-1780
Practice Address - Street 1:31 MOUNTAIN BLVD
Practice Address - Street 2:SUITE 31W
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5644
Practice Address - Country:US
Practice Address - Phone:908-769-8582
Practice Address - Fax:908-222-1780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-11
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25 MA07175700261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health