Provider Demographics
NPI:1588846398
Name:LIENGKONG SIEW MD INC
Entity Type:Organization
Organization Name:LIENGKONG SIEW MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LIENGKONG
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-323-5055
Mailing Address - Street 1:507 EAST RIVER ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035
Mailing Address - Country:US
Mailing Address - Phone:440-323-5055
Mailing Address - Fax:440-323-0759
Practice Address - Street 1:507 EAST RIVER ST
Practice Address - Street 2:SUITE B
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035
Practice Address - Country:US
Practice Address - Phone:440-323-5055
Practice Address - Fax:440-323-0759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0248379Medicaid
9205921Medicare PIN