Healthcare Provider Details

I. General information

NPI: 1285666933
Provider Name (Legal Business Name): DANNY LIU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 05/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 MAIN DR
NORTH WARREN PA
16365-5001
US

IV. Provider business mailing address

201 N STATE ST
NORTH WARREN PA
16365-5005
US

V. Phone/Fax

Practice location:
  • Phone: 814-726-4317
  • Fax: 814-726-4447
Mailing address:
  • Phone: 814-726-0573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD054161L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: