Provider Demographics
NPI:1952503666
Name:ZOE LIU MEDICAL OFFICE PC
Entity Type:Organization
Organization Name:ZOE LIU MEDICAL OFFICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ZOE
Authorized Official - Middle Name:ZHECHUN
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-966-2699
Mailing Address - Street 1:98 E BROADWAY FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-7181
Mailing Address - Country:US
Mailing Address - Phone:212-966-2699
Mailing Address - Fax:212-966-1206
Practice Address - Street 1:847 57TH ST # 901
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-6852
Practice Address - Country:US
Practice Address - Phone:718-686-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY221999207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02182369Medicaid
NY02182369Medicaid
NYH55825Medicare UPIN