Individual provider Active NPI

Connie Liou, MD

  • Vascular & Interventional Radiology Physician
  • New York, NY
National Provider Identifier
1396308763
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
316327-01 Issued in NY
Practice address
177 Fort Washington Ave
New York, NY 10032-3733
Phone
(212) 305-2500
NPI assigned
Apr 20, 2019
Last updated
Jun 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 316327-01 NY Primary
Vascular & Interventional Radiology Physician 2085R0204X MD.MD.70111705 WA

Addresses

Primary practice location

177 Fort Washington Ave
New York, NY 10032-3733

Mailing address

200 W 95TH St
New York, NY 10025-6306

Other practice location 1

1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900
Phone (253) 761-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Warren Alpert Medical School of Brown University, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1304 Fawcett Ave
Suite 100
Tacoma, WA 98402-1905

2 Meridian Blvd
FL 3
Wyomissing, PA 19610-3202

PO Box
Suite 1535
Tacoma, WA 98401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
316327-01NYMDVascular & Interventional Radiology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1396308763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W 95TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 FORT WASHINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323733",
            "telephone_number": "212-305-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1304 Fawcett Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984021900",
            "country_code": "US",
            "telephone_number": "253-761-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIOU",
        "first_name": "CONNIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-20",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "316327-01",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WA",
            "license": "MD.MD.70111705",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.