Provider Demographics
NPI:1730470865
Name:LIU, LORA
Entity Type:Individual
Prefix:
First Name:LORA
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 S ORANGE AVE # 254
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1702
Mailing Address - Country:US
Mailing Address - Phone:212-381-0796
Mailing Address - Fax:646-248-5182
Practice Address - Street 1:377 JERSEY AVE STE 220
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-4396
Practice Address - Country:US
Practice Address - Phone:212-381-0796
Practice Address - Fax:646-248-5182
Is Sole Proprietor?:No
Enumeration Date:2011-04-24
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY268428207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology