Provider Demographics
NPI:1538488127
Name:FRONTIER MEDICAL SERVICES PLLC
Entity type:Organization
Organization Name:FRONTIER MEDICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:REN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-339-1700
Mailing Address - Street 1:PO BOX 79
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-0079
Mailing Address - Country:US
Mailing Address - Phone:201-339-1700
Mailing Address - Fax:201-339-6972
Practice Address - Street 1:210 CANAL ST
Practice Address - Street 2:SUITE 601
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4155
Practice Address - Country:US
Practice Address - Phone:201-339-1700
Practice Address - Fax:201-339-6972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty