Individual
MR. JERRY LIAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3050 WHITE PLAINS RD, BRONX, NY 10467-8154
(929) 348-4794
Mailing address
3050 WHITE PLAINS RD, BRONX, NY 10467-8154
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
707195
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F403575
NY
Other
Enumeration date
01/30/2018
Last updated
01/30/2023
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