=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205510450
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HUI-HSIN LIU L.AC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/09/2023
-----------------------------------------------------
Last Update Date | 06/09/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20 COUNTRY ESTATES RD
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12083-3414
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-966-6920
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 915 STATE ROUTE 143
-----------------------------------------------------
City | WESTERLO
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12193-2336
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 007315
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------