Healthcare Provider Details

I. General information

NPI: 1932809910
Provider Name (Legal Business Name): HAIFANG LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2023
Last Update Date: 03/07/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 W MAIN ST
OYSTER BAY NY
11771-2262
US

IV. Provider business mailing address

14431 41ST AVE APT L3
FLUSHING NY
11355-1452
US

V. Phone/Fax

Practice location:
  • Phone: 516-446-8369
  • Fax:
Mailing address:
  • Phone: 646-520-8986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number030979
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number007229
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: