Healthcare Provider Details
I. General information
NPI: 1023062429
Provider Name (Legal Business Name): LIU AND ASSOCIATES FAMILY MEDICINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/20/2006
Last Update Date: 09/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1251 S CEDAR CREST BLVD SUITE 102A
ALLENTOWN PA
18103-6205
US
IV. Provider business mailing address
1650 VALLEY CENTER PKWY SUITE 100
BETHLEHEM PA
18017-2344
US
V. Phone/Fax
- Phone: 610-776-0377
- Fax:
- Phone: 484-884-4436
- Fax: 484-884-4444
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | PA |
VIII. Authorized Official
Name:
HENRY
LIU
Title or Position: PRESIDENT
Credential: MD
Phone: 640-776-0377