Healthcare Provider Details

I. General information

NPI: 1578480604
Provider Name (Legal Business Name): ALLEN LIU LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 SUNRISE HWY STE 200
LYNBROOK NY
11563-2950
US

IV. Provider business mailing address

622 W 141ST ST APT 7B
NEW YORK NY
10031-7141
US

V. Phone/Fax

Practice location:
  • Phone: 516-350-8564
  • Fax:
Mailing address:
  • Phone: 347-397-0462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number131548
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: