Provider Demographics
NPI:1841859162
Name:TIAN, LIKUN (MD)
Entity type:Individual
Prefix:
First Name:LIKUN
Middle Name:
Last Name:TIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:TIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:660 WHITE PLAINS RD STE 400
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5107
Mailing Address - Country:US
Mailing Address - Phone:914-984-2546
Mailing Address - Fax:
Practice Address - Street 1:150 E 58TH ST FL 34
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10155-3499
Practice Address - Country:US
Practice Address - Phone:212-722-5570
Practice Address - Fax:212-722-4573
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332208207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology