Healthcare Provider Details

I. General information

NPI: 1083351795
Provider Name (Legal Business Name): LIYU LIU MS. L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2022
Last Update Date: 03/20/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136-20 38TH AVE 3F-105
FLUSHING NY
11354
US

IV. Provider business mailing address

14351 ROOSEVELT AVE APT 15J
FLUSHING NY
11354-6195
US

V. Phone/Fax

Practice location:
  • Phone: 929-371-5588
  • Fax:
Mailing address:
  • Phone: 646-696-8581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number031989-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number007186
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: