Provider Demographics
NPI:1548081706
Name:LIU, YUCHENG
Entity type:Individual
Prefix:
First Name:YUCHENG
Middle Name:
Last Name:LIU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:393 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-5045
Mailing Address - Country:US
Mailing Address - Phone:323-696-3990
Mailing Address - Fax:
Practice Address - Street 1:393 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-5045
Practice Address - Country:US
Practice Address - Phone:323-696-3990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0002502085R0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0205XAllopathic & Osteopathic PhysiciansRadiologyRadiological PhysicsGroup - Single Specialty