Healthcare Provider Details

I. General information

NPI: 1417485699
Provider Name (Legal Business Name): FRANK LIU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2017
Last Update Date: 01/26/2021
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 S 5TH AVE
WEST READING PA
19611-2143
US

IV. Provider business mailing address

1701 CORNWALL RD STE 101
LANCASTER PA
17601
US

V. Phone/Fax

Practice location:
  • Phone: 484-628-8640
  • Fax: 484-628-5064
Mailing address:
  • Phone: 717-675-1788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMT213275
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD471617
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: