Healthcare Provider Details

I. General information

NPI: 1164514964
Provider Name (Legal Business Name): L & Y MEDICAL ASSOCIATE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36-09 MAIN ST SUITE 202
FLUSHING NY
11354
US

IV. Provider business mailing address

36-09 MAIN ST SUITE 202
FLUSHING NY
11354
US

V. Phone/Fax

Practice location:
  • Phone: 718-321-7558
  • Fax: 718-321-3555
Mailing address:
  • Phone: 718-321-7558
  • Fax: 718-321-3555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: WEINING W LIANG
Title or Position: MD
Credential: MD
Phone: 718-321-7558