Provider Demographics
NPI:1740834100
Name:LIANG, YUBIN
Entity type:Individual
Prefix:
First Name:YUBIN
Middle Name:
Last Name:LIANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 MAIN ST APT 401
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-4722
Mailing Address - Country:US
Mailing Address - Phone:475-731-1716
Mailing Address - Fax:
Practice Address - Street 1:136 DOWD AVE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:CT
Practice Address - Zip Code:06019-2438
Practice Address - Country:US
Practice Address - Phone:475-731-1716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT14228613171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist