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General NPI Number Information
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NPI Number | 1801758925
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Entity Type | Individual
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Provider Name | JIETAO LIANG
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Gender | Male
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Dates
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Enumeration Date | 11/26/2025
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 323 OLD YORK RD
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City | JENKINTOWN
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State | PA
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Zip | 19046-4002
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Country | US
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Telephone | 215-886-6925
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Fax | 215-886-6992
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Provider Business Mailing Address
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Address Line | 8833 HARGRAVE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19152-1510
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP460066
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI04472100
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License Number State | NJ
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