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General NPI Number Information
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NPI Number | 1467037366
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Entity Type | Individual
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Provider Name | MEI FANG LIAO NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 03/11/2021
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Last Update Date | 03/11/2021
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Provider Practice Location Address
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Address Line | 863 50TH ST APT M6
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City | BROOKLYN
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State | NY
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Zip | 11220-2417
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Country | US
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Telephone | 347-240-8482
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Fax | 718-878-5708
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Provider Business Mailing Address
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Address Line | 2021 E 29TH ST
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City | BROOKLYN
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State | NY
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Zip | 11229-5049
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Country | US
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Telephone | 347-410-2366
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F346324-01
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License Number State | NY
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