Provider Demographics
NPI:1194005611
Name:JIAN Q LIANG DPM P C
Entity Type:Organization
Organization Name:JIAN Q LIANG DPM P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JIAN
Authorized Official - Middle Name:Q
Authorized Official - Last Name:LIANG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:212-619-2539
Mailing Address - Street 1:139 CENTRE ST STE 211
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4553
Mailing Address - Country:US
Mailing Address - Phone:212-619-2539
Mailing Address - Fax:212-871-0020
Practice Address - Street 1:139 CENTRE ST STE 211
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4553
Practice Address - Country:US
Practice Address - Phone:212-619-2539
Practice Address - Fax:212-871-0020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-29
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005666213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03444126Medicaid
NY03444126Medicaid
NYA100055798Medicare PIN