Provider Demographics
NPI:1366692352
Name:LIU-JARIN, XIAOLIN (MD)
Entity Type:Individual
Prefix:
First Name:XIAOLIN
Middle Name:
Last Name:LIU-JARIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:XIAOLIN
Other - Middle Name:
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:630 WEST 168TH ST
Mailing Address - Street 2:PH 1564W
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10032
Mailing Address - Country:US
Mailing Address - Phone:201-393-5914
Mailing Address - Fax:201-462-4706
Practice Address - Street 1:630 WEST 168TH ST
Practice Address - Street 2:
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:212-305-7399
Practice Address - Fax:201-462-4706
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222355-1207ZP0101X
NJ25MA07350300207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH67141Medicare UPIN