Provider Demographics
NPI:1679674816
Name:LIU, XIAOMING (MD)
Entity Type:Individual
Prefix:DR
First Name:XIAOMING
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 STREAM BANK DR.
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-9552
Mailing Address - Country:US
Mailing Address - Phone:732-677-2911
Mailing Address - Fax:
Practice Address - Street 1:4677 US HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3384
Practice Address - Country:US
Practice Address - Phone:732-901-7786
Practice Address - Fax:732-901-4080
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2010-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07940400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJI42417Medicare UPIN
NJ094852Medicare ID - Type Unspecified