Provider Demographics
NPI:1407085913
Name:LIAO, SHUIFA
Entity Type:Individual
Prefix:
First Name:SHUIFA
Middle Name:
Last Name:LIAO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:SHUIFA
Other - Middle Name:
Other - Last Name:LIAO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4 PRIORY RD
Mailing Address - Street 2:
Mailing Address - City:WEST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08550
Mailing Address - Country:US
Mailing Address - Phone:609-799-4660
Mailing Address - Fax:609-799-4660
Practice Address - Street 1:201 N. HERMITAGE AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08609
Practice Address - Country:US
Practice Address - Phone:609-396-6167
Practice Address - Fax:609-396-8615
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02762800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist