MEDICARE: BENJAMIN 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	225100000X	Physical Therapist		NY

General Provider Information

NPI Number	:	1952236986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN LIU

Provider Business Mailing Address
First Line	:	4 TERRACE CIR APT 1E
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11021-4115
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	83 FOREST AVE
Second Line	:
City	:	GLEN COVE
State	:	NY
Zip	:	11542-2115
Country	:	US
Telephone Number	:	516-464-2346
Fax Number	:

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

Provider Enumeration Date	:	06/12/2026
Last Update Date	:	06/12/2026

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Directions to “ BENJAMIN LIU ” Practice Location

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