Healthcare Provider Details

I. General information

NPI: 1225039415
Provider Name (Legal Business Name): BEIQING LIU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 S MANNING BLVD MAPLEWOOD PATHOLOGY
ALBANY NY
12208-1707
US

IV. Provider business mailing address

PO BOX 8870 MAPLEWOOD PATHOLOGY
ALBANY NY
12208-0870
US

V. Phone/Fax

Practice location:
  • Phone: 518-525-1474
  • Fax:
Mailing address:
  • Phone: 518-525-1474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number229030
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: