Provider Demographics
NPI:1194460717
Name:LIU, RICARDA LENG (MSN AGNP-C)
Entity type:Individual
Prefix:
First Name:RICARDA
Middle Name:LENG
Last Name:LIU
Suffix:
Gender:F
Credentials:MSN AGNP-C
Other - Prefix:
Other - First Name:RICARDA
Other - Middle Name:
Other - Last Name:LENG LIU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN AGNP-C
Mailing Address - Street 1:3611 14TH AVE STE 550
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-3773
Mailing Address - Country:US
Mailing Address - Phone:718-819-6144
Mailing Address - Fax:718-819-6145
Practice Address - Street 1:3611 14TH AVE STE 550
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-3773
Practice Address - Country:US
Practice Address - Phone:718-819-6144
Practice Address - Fax:718-819-6145
Is Sole Proprietor?:No
Enumeration Date:2022-04-28
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF310421363LA2200X
NY310421363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner