MEDICARE: AMY LIU RPH

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	183500000X	Pharmacist	068214	NY

General Provider Information

NPI Number	:	1609547645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY LIU RPH

Provider Business Mailing Address
First Line	:	46D PEARSALL ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10305-4218
Country	:	US
Telephone Number	:	718-755-4588
Fax Number	:

Provider Business Practice Location Address
First Line	:	6910 3RD AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-1305
Country	:	US
Telephone Number	:	718-680-2229
Fax Number	:

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

Provider Enumeration Date	:	09/21/2021
Last Update Date	:	09/21/2021

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Directions to “ AMY LIU RPH” Practice Location

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