Healthcare Provider Details

I. General information

NPI: 1700422037
Provider Name (Legal Business Name): ZHIXI LIU LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2019
Last Update Date: 01/08/2020
Certification Date: 01/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4277 65TH PL
WOODSIDE NY
11377-5054
US

IV. Provider business mailing address

435 W 31ST ST
NEW YORK NY
10001-4658
US

V. Phone/Fax

Practice location:
  • Phone: 718-429-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number107436
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: