Provider Demographics
NPI:1790711695
Name:LIU, DAVID P C (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:P C
Last Name:LIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 GUSTAVE L. LEVY PLACE
Mailing Address - Street 2:BOX 1194
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6574
Mailing Address - Country:US
Mailing Address - Phone:212-241-8395
Mailing Address - Fax:212-289-0092
Practice Address - Street 1:144 4TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4901
Practice Address - Country:US
Practice Address - Phone:212-473-2300
Practice Address - Fax:212-473-4780
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2015-01-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1547002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04F661Medicare PIN
D93147Medicare UPIN
NY01284537Medicaid