Provider Demographics
NPI:1720009434
Name:LIU, LAURIE-ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:LAURIE-ANN
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1570 CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:EDDYSTONE
Mailing Address - State:PA
Mailing Address - Zip Code:19022-1338
Mailing Address - Country:US
Mailing Address - Phone:610-447-1878
Mailing Address - Fax:
Practice Address - Street 1:1570 CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:EDDYSTONE
Practice Address - State:PA
Practice Address - Zip Code:19022-1338
Practice Address - Country:US
Practice Address - Phone:610-447-1878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000438152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist