Healthcare Provider Details

I. General information

NPI: 1033837596
Provider Name (Legal Business Name): JOY LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2022
Last Update Date: 08/19/2022
Certification Date: 08/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 ELDRIDGE ST
NEW YORK NY
10002-2924
US

IV. Provider business mailing address

366 BUTLER ST APT 1
BROOKLYN NY
11217-3103
US

V. Phone/Fax

Practice location:
  • Phone: 760-658-3789
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number117077-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: