Healthcare Provider Details

I. General information

NPI: 1356815849
Provider Name (Legal Business Name): JING J. LIU MD(CHINA),PHD,LI.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2019
Last Update Date: 10/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1018 COMMONWEALTH AVE, SUITE 3
BOSTON MA
02215-1139
US

IV. Provider business mailing address

1018 COMMONWEALTH AVE, SUITE 3
BOSTON MA
02215-1139
US

V. Phone/Fax

Practice location:
  • Phone: 857-288-8322
  • Fax:
Mailing address:
  • Phone: 857-288-8322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: