MEDICARE: EMILY LIU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	1658688221	NY

General Provider Information

NPI Number	:	1245125632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY LIU

Provider Business Mailing Address
First Line	:	210 UNION AVE APT 2
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13203-1746
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2555 HAMBLETONIAN WAY
Second Line	:
City	:	CAMILLUS
State	:	NY
Zip	:	13031-8640
Country	:	US
Telephone Number	:	315-227-2555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2025
Last Update Date	:	06/09/2025

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Directions to “ EMILY LIU ” Practice Location

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