Provider Demographics
NPI:1215002761
Name:LIANG, VERA T (MD)
Entity Type:Individual
Prefix:DR
First Name:VERA
Middle Name:T
Last Name:LIANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VERA
Other - Middle Name:B TSAI
Other - Last Name:LIANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:555 BROADHOLLOW RD STE 203
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-5001
Mailing Address - Country:US
Mailing Address - Phone:516-484-5869
Mailing Address - Fax:
Practice Address - Street 1:555 BROADHOLLOW RD STE 203
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-5001
Practice Address - Country:US
Practice Address - Phone:516-484-5869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1176272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY305341Medicare ID - Type Unspecified
NYB12624Medicare UPIN