Individual
JIMMY LIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-5731
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
062509
NY
Other
Enumeration date
03/01/2021
Last updated
04/24/2023
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