Provider Demographics
NPI:1518129154
Name:LIU, XIN (MD)
Entity Type:Individual
Prefix:
First Name:XIN
Middle Name:
Last Name:LIU
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 1:414 LAUREL CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3968
Mailing Address - Country:US
Mailing Address - Phone:302-317-1531
Mailing Address - Fax:302-291-4986
Practice Address - Street 1:2400 PHILADELPHIA PIKE STE A
Practice Address - Street 2:
Practice Address - City:CLAYMONT
Practice Address - State:DE
Practice Address - Zip Code:19703-2431
Practice Address - Country:US
Practice Address - Phone:302-317-1531
Practice Address - Fax:302-291-4986
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD433848207L00000X
DEC1-0009015207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102311316Medicaid
PA44030OtherABA CERTIFICATE #
PAP00740153OtherRAILROAD MEDICARE
DEP00847920OtherRAILROAD MEDICARE
DE158574Medicare PIN
PAP00740153OtherRAILROAD MEDICARE