Basic Information
| Provider Information | |||||||||
| NPI: | 1487790663 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | UNIVERSITY PSYCHIATRIC ASSOCIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 115 PARLIN LN | ||||||||
| Address2: | |||||||||
| City: | WATCHUNG | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070695400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9739722977 | ||||||||
| FaxNumber: | 9739722979 | ||||||||
| Practice Location | |||||||||
| Address1: | UPA | ||||||||
| Address2: | 183 SOUTH ORANGE AVE | ||||||||
| City: | NEWARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9739722977 | ||||||||
| FaxNumber: | 9739732979 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | LIU | ||||||||
| AuthorizedOfficialFirstName: | QIN-YUE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | ASSISTANT PROFESSOR | ||||||||
| AuthorizedOfficialTelephone: | 9739722977 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 25MA07175700 | NJ | Y | Hospitals | General Acute Care Hospital |
No ID Information.