Healthcare Provider Details

I. General information

NPI: 1841188778
Provider Name (Legal Business Name): LANLI LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 06/27/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 UNION TPKE STE 103A
NEW HYDE PARK NY
11040-1759
US

IV. Provider business mailing address

7308 187TH ST
FRESH MEADOWS NY
11366-1724
US

V. Phone/Fax

Practice location:
  • Phone: 917-868-1794
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number007754
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: