Healthcare Provider Details

I. General information

NPI: 1205592839
Provider Name (Legal Business Name): RACHEL LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 5TH AVE RM 903A
NEW YORK NY
10011-7611
US

IV. Provider business mailing address

5008 175TH PL
FRESH MEADOWS NY
11365-1626
US

V. Phone/Fax

Practice location:
  • Phone: 917-213-6112
  • Fax:
Mailing address:
  • Phone: 917-213-6112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: