Provider Demographics
NPI:1134269467
Name:LIU, ZACH (MD)
Entity type:Individual
Prefix:DR
First Name:ZACH
Middle Name:
Last Name:LIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 E CRESCENT AVE
Mailing Address - Street 2:C/O HISTOPATHOLOGY SERVICES, LLC
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2922
Mailing Address - Country:US
Mailing Address - Phone:201-661-7280
Mailing Address - Fax:201-661-7297
Practice Address - Street 1:535 E CRESCENT AVE
Practice Address - Street 2:C/O HISTOPATHOLOGY SERVICES, LLC
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-2922
Practice Address - Country:US
Practice Address - Phone:201-661-7280
Practice Address - Fax:201-661-7297
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06536400207ZH0000X, 207ZP0102X
NY205122207ZH0000X, 207ZP0102X
FLME113633207ZH0000X, 207ZP0102X
MDD0075223207ZH0000X, 207ZP0102X
NJ25MF00082600207ZP0102X, 207ZH0000X
VT042.0013940207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400022797Medicare UPIN
NJ230145TGNMedicare PIN