Healthcare Provider Details

I. General information

NPI: 1932696176
Provider Name (Legal Business Name): MINXIAN LIANG MB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2018
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 BROOKLINE AVE DEPARTMENT OF ANESTHESIA
BOSTON MA
02215
US

IV. Provider business mailing address

330 BROOKLINE AVE
BOSTON MA
02215-5491
US

V. Phone/Fax

Practice location:
  • Phone: 617-667-5048
  • Fax:
Mailing address:
  • Phone: 617-755-8261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number1022263
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: