Provider Demographics
NPI:1609404078
Name:LIENG, MONICA K (MD, PHD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:K
Last Name:LIENG
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 EDDY ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4923
Mailing Address - Country:US
Mailing Address - Phone:401-444-5127
Mailing Address - Fax:401-444-3056
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-444-5127
Practice Address - Fax:401-444-3056
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2022-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
RICLP05747OtherCSR-LIMITED PHYSICIAN
RILP05747OtherLIMITED PROVIDER