Provider Demographics
NPI:1114303492
Name:LIU, XIAOSHI CECILIA (PHARMD)
Entity Type:Individual
Prefix:
First Name:XIAOSHI
Middle Name:CECILIA
Last Name:LIU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2318 60TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-2630
Mailing Address - Country:US
Mailing Address - Phone:718-666-6130
Mailing Address - Fax:
Practice Address - Street 1:2318 60TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-2630
Practice Address - Country:US
Practice Address - Phone:718-666-6130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060919183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist