MEDICARE: DR. XIAOGUANG LIU M.D.

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	208100000X	Physical Medicine & Rehabilitation Physician	233485	NY
2	2081H0002X	Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician	25MA08241100	NJ
3	2081H0002X	Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician	233485	NY

General Provider Information

NPI Number	:	1386851251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. XIAOGUANG LIU M.D.

Provider Business Mailing Address
First Line	:	730 FORT WASHINGTON AVE APT 3N
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10040-3745
Country	:	US
Telephone Number	:	718-530-5267
Fax Number	:	646-669-8192

Provider Business Practice Location Address
First Line	:	427 FORT WASHINGTON AVE APT 1A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10033-3522
Country	:	US
Telephone Number	:	718-530-5267
Fax Number	:	646-669-8192

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

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	05/06/2024

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