MEDICARE: DR. CATHERINE LIU PHARMD, BCGP, BCPS

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	183500000X	Pharmacist	PCT.0013719	CT
2	1835G0303X	Geriatric Pharmacist	064138	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	064138	OTHER	NY	NEW YORK PHARMACIST LICENSE

General Provider Information

NPI Number	:	1952858979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CATHERINE LIU PHARMD, BCGP, BCPS

Provider Business Mailing Address
First Line	:	950 CAMPBELL AVE
Second Line	:
City	:	WEST HAVEN
State	:	CT
Zip	:	06516-2770
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	230 W 125TH ST FL 5
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10027-4402
Country	:	US
Telephone Number	:	212-851-1192
Fax Number	:

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

Provider Enumeration Date	:	09/07/2016
Last Update Date	:	04/20/2020

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