Healthcare Provider Details

I. General information

NPI: 1366920449
Provider Name (Legal Business Name): HENG LIU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2018
Last Update Date: 08/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 BAY RIDGE PKWY
BROOKLYN NY
12204
US

IV. Provider business mailing address

1775 BAY RIDGE PKWY
BROOKLYN NY
12204
US

V. Phone/Fax

Practice location:
  • Phone: 718-855-5566
  • Fax:
Mailing address:
  • Phone: 718-855-5566
  • Fax: 718-504-7308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number002495
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: