Provider Demographics
NPI:1235728262
Name:LIAO, JIAHUI (PHARMD)
Entity Type:Individual
Prefix:
First Name:JIAHUI
Middle Name:
Last Name:LIAO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 BLUE HILL AVE
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-1150
Mailing Address - Country:US
Mailing Address - Phone:857-413-0348
Mailing Address - Fax:
Practice Address - Street 1:42 BEALE ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02170-2617
Practice Address - Country:US
Practice Address - Phone:617-471-7451
Practice Address - Fax:617-472-7174
Is Sole Proprietor?:No
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH234984183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist