Provider Demographics
NPI:1053507301
Name:LIAO ACUPUNCTURE GROUP, LLC
Entity Type:Organization
Organization Name:LIAO ACUPUNCTURE GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER, LIAO ACUPUNCTURE GROUP, LLC
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LIAO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:410-825-6667
Mailing Address - Street 1:7600 OSLER DR
Mailing Address - Street 2:ROOM 215
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7735
Mailing Address - Country:US
Mailing Address - Phone:410-825-6667
Mailing Address - Fax:410-828-1638
Practice Address - Street 1:7600 OSLER DR
Practice Address - Street 2:ROOM 215
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7735
Practice Address - Country:US
Practice Address - Phone:410-825-6667
Practice Address - Fax:410-828-1638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0014526171100000X, 2084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD911MMedicare PIN