Provider Demographics
NPI:1760613228
Name:LIU, LINGLING (MD)
Entity Type:Individual
Prefix:DR
First Name:LINGLING
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 1:63 FOREST HILL PKWY
Mailing Address - Street 2:APT # 3G
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07104-4701
Mailing Address - Country:US
Mailing Address - Phone:703-465-9412
Mailing Address - Fax:
Practice Address - Street 1:63 FOREST HILL PKWY
Practice Address - Street 2:APT # 3G
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07104-4701
Practice Address - Country:US
Practice Address - Phone:703-465-9412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-01
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD040697207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine