MEDICARE: SHIRLEY LIANG FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	351394	NY

General Provider Information

NPI Number	:	1255016267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIRLEY LIANG FNP

Provider Business Mailing Address
First Line	:	2138 78TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-1502
Country	:	US
Telephone Number	:	646-350-9871
Fax Number	:

Provider Business Practice Location Address
First Line	:	5022 FORT HAMILTON PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-3324
Country	:	US
Telephone Number	:	718-635-9700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2023
Last Update Date	:	07/03/2025

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