Provider Demographics
NPI:1639513591
Name:LIU, CORNELIA H (DMD)
Entity type:Individual
Prefix:DR
First Name:CORNELIA
Middle Name:H
Last Name:LIU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 BLOOMFIELD AVE
Mailing Address - Street 2:CALDWELL
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-5550
Mailing Address - Country:US
Mailing Address - Phone:201-207-3173
Mailing Address - Fax:
Practice Address - Street 1:519 BLOOMFIELD AVE
Practice Address - Street 2:CALDWELL
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-5550
Practice Address - Country:US
Practice Address - Phone:201-207-3173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program