Healthcare Provider Details

I. General information

NPI: 1568998375
Provider Name (Legal Business Name): ERIC LIU DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 05/17/2025
Certification Date: 05/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S HENDERSON RD STE 308C
KING OF PRUSSIA PA
19406-4206
US

IV. Provider business mailing address

706 LATONA ST UNIT D
PHILADELPHIA PA
19147-5168
US

V. Phone/Fax

Practice location:
  • Phone: 610-337-3111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberOS021329
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: