Provider Demographics
NPI:1972018570
Name:LIU, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:LIU
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 1:7397 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1721
Mailing Address - Country:US
Mailing Address - Phone:703-573-0177
Mailing Address - Fax:
Practice Address - Street 1:7397 LEE HWY
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1721
Practice Address - Country:US
Practice Address - Phone:703-573-0177
Practice Address - Fax:703-573-4233
Is Sole Proprietor?:No
Enumeration Date:2017-12-06
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202215431183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist