MEDICARE: JIETAO LIANG

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	RP460066	PA
2	183500000X	Pharmacist	28RI04472100	NJ

General Provider Information

NPI Number	:	1801758925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIETAO LIANG

Provider Business Mailing Address
First Line	:	8833 HARGRAVE ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-1510
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	323 OLD YORK RD
Second Line	:
City	:	JENKINTOWN
State	:	PA
Zip	:	19046-4002
Country	:	US
Telephone Number	:	215-886-6925
Fax Number	:	215-886-6992

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

Provider Enumeration Date	:	11/26/2025
Last Update Date	:	01/30/2026

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Directions to “ JIETAO LIANG ” Practice Location

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