Healthcare Provider Details

I. General information

NPI: 1558852822
Provider Name (Legal Business Name): DAVID YANG LIU DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2018
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 BROOKLINE AVE DEACONESS 311
BOSTON MA
02215-5491
US

IV. Provider business mailing address

330 BROOKLINE AVE DEACONESS 311
BOSTON MA
02215-5400
US

V. Phone/Fax

Practice location:
  • Phone: 617-667-9600
  • Fax: 508-830-2702
Mailing address:
  • Phone: 617-677-9600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number1017346
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: