Provider Demographics
NPI:1952910762
Name:LIAO, YI-CHING (RD)
Entity Type:Individual
Prefix:
First Name:YI-CHING
Middle Name:
Last Name:LIAO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2463 CRESCENT ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-2838
Mailing Address - Country:US
Mailing Address - Phone:206-928-1060
Mailing Address - Fax:
Practice Address - Street 1:2463 CRESCENT ST UNIT 1
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-2838
Practice Address - Country:US
Practice Address - Phone:206-928-1060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered