Healthcare Provider Details

I. General information

NPI: 1427174481
Provider Name (Legal Business Name): JILIANG LIU TCMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 E 55TH ST SUITE 6G
NEW YORK NY
10022-4030
US

IV. Provider business mailing address

9 W MILL DR 3-12C
GREAT NECK NY
11021-4048
US

V. Phone/Fax

Practice location:
  • Phone: 212-486-3620
  • Fax: 212-486-3620
Mailing address:
  • Phone: 516-482-3511
  • Fax: 516-482-3511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number001173
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: