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General NPI Number Information
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NPI Number | 1144895517
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Entity Type | Individual
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Provider Name | MONICA LIANG
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Gender | Female
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Dates
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Enumeration Date | 05/26/2021
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Last Update Date | 12/09/2022
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Provider Practice Location Address
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Address Line | 78 BRICKYARD RD
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City | ATHOL
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State | MA
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Zip | 01331-2051
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Country | US
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Telephone | 978-581-1970
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Fax |
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Provider Business Mailing Address
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Address Line | 178 VERNON AVE
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City | YONKERS
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State | NY
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Zip | 10704-2468
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Country | US
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Telephone | 860-373-8979
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN1859641
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License Number State | MA
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