Healthcare Provider Details

I. General information

NPI: 1255749156
Provider Name (Legal Business Name): JOYCE LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2014
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 3RD AVE
NEW YORK NY
10029-4605
US

IV. Provider business mailing address

2037 76TH ST FL 2
BROOKLYN NY
11214-1305
US

V. Phone/Fax

Practice location:
  • Phone: 917-492-1038
  • Fax:
Mailing address:
  • Phone: 646-571-9532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number059426
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: