Individual
DR. LIQI FAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
225 WILLIAMSON ST, ELIZABETH, NJ 07202-3625
(908) 994-5422
Mailing address
17 WARNER RD, MAPLEWOOD, NJ 07040-2010
(860) 869-7642
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA09230800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0379140
—
NJ
Enumeration date
01/26/2011
Last updated
06/09/2023
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