Provider Demographics
NPI:1689620577
Name:LIU, ANGELA N (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:N
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:DAVIS AVE AT E POST RD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4615
Mailing Address - Country:US
Mailing Address - Phone:914-681-0600
Mailing Address - Fax:
Practice Address - Street 1:DAVIS AVE AT E POST RD
Practice Address - Street 2:HOSPITALIST DEPT
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4615
Practice Address - Country:US
Practice Address - Phone:914-681-0600
Practice Address - Fax:914-681-2285
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY218833207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3661605OtherCIGNA
I67958Medicare UPIN
NY3661605OtherCIGNA