Healthcare Provider Details

I. General information

NPI: 1538209952
Provider Name (Legal Business Name): MONHSIA LIU NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 JAY ST
BROOKLYN NY
11201-1144
US

IV. Provider business mailing address

54 BOERUM ST
BROOKLYN NY
11206-2435
US

V. Phone/Fax

Practice location:
  • Phone: 718-222-6600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number334321
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: