Provider Demographics
NPI:1821304973
Name:LIU, YANNAN N (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:YANNAN
Middle Name:N
Last Name:LIU
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 WARREN MANOR CT
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030-2759
Mailing Address - Country:US
Mailing Address - Phone:410-628-4820
Mailing Address - Fax:
Practice Address - Street 1:3425 BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-1246
Practice Address - Country:US
Practice Address - Phone:410-628-4820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14581183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist