Healthcare Provider Details

I. General information

NPI: 1689949455
Provider Name (Legal Business Name): Q. ANNA LIU LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2012
Last Update Date: 05/25/2020
Certification Date: 05/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 REMSEN ST 4TH FLOOR
BROOKLYN NY
11201-4333
US

IV. Provider business mailing address

175 REMSEN ST 4TH FLOOR
BROOKLYN NY
11201-4333
US

V. Phone/Fax

Practice location:
  • Phone: 347-819-5583
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number080146-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: