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General NPI Number Information
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NPI Number | 1275131229
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Entity Type | Individual
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Provider Name | DAKAI LIU PHD
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Gender | Male
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Dates
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Enumeration Date | 10/13/2020
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Last Update Date | 10/13/2020
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Provider Practice Location Address
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Address Line | 5645 MAIN ST
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City | FLUSHING
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State | NY
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Zip | 11355-5045
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Country | US
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Telephone | 718-670-1455
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Fax |
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Provider Business Mailing Address
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Address Line | 12 HANCOCK CT
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City | SOUTH SETAUKET
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State | NY
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Zip | 11720-4611
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Country | US
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Telephone | 631-764-8226
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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 | 207ZC0006X
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Taxonomy Name | Clinical Pathology Physician
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License Number | LIUXD3
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 246QL0900X
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Taxonomy Name | Laboratory Management Specialist/Technologist
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License Number | 016532
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License Number State | NY
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