Healthcare Provider Details

I. General information

NPI: 1497453260
Provider Name (Legal Business Name): WEI HONG LIU PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2023
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 5TH AVE FL 2
NEW YORK NY
10011-4367
US

IV. Provider business mailing address

13433 BLOSSOM AVE APT 1E
FLUSHING NY
11355-4631
US

V. Phone/Fax

Practice location:
  • Phone: 855-216-7674
  • Fax:
Mailing address:
  • Phone: 646-369-8829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number048970
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number048970
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: