MEDICARE: VIVIAN 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	224Z00000X	Occupational Therapy Assistant	0423425	NY

General Provider Information

NPI Number	:	1437617883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIVIAN LIU

Provider Business Mailing Address
First Line	:	5805 7TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3964
Country	:	US
Telephone Number	:	718-439-8816
Fax Number	:

Provider Business Practice Location Address
First Line	:	5805 7TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3964
Country	:	US
Telephone Number	:	718-439-8816
Fax Number	:

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

Provider Enumeration Date	:	03/05/2019
Last Update Date	:	03/05/2019

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Directions to “ VIVIAN LIU ” Practice Location

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