Healthcare Provider Details

I. General information

NPI: 1205589736
Provider Name (Legal Business Name): MEIZHIHONG LIU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2022
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3218 154TH ST
FLUSHING NY
11354-3321
US

IV. Provider business mailing address

3218 154TH ST
FLUSHING NY
11354-3321
US

V. Phone/Fax

Practice location:
  • Phone: 347-484-5495
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number068789
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: