Provider Demographics
NPI:1003615758
Name:LIZ WELLNESS NEW YORK LLC
Entity type:Organization
Organization Name:LIZ WELLNESS NEW YORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAC
Authorized Official - Prefix:
Authorized Official - First Name:LI
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-568-1632
Mailing Address - Street 1:4664 189TH ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-3833
Mailing Address - Country:US
Mailing Address - Phone:631-568-1632
Mailing Address - Fax:
Practice Address - Street 1:4664 189TH ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-3833
Practice Address - Country:US
Practice Address - Phone:631-568-1632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty