Provider Demographics
NPI:1013512821
Name:LIU, HAN (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:HAN
Middle Name:
Last Name:LIU
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 CORDING LN
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-2717
Mailing Address - Country:US
Mailing Address - Phone:914-357-3626
Mailing Address - Fax:
Practice Address - Street 1:1024 BROADWAY
Practice Address - Street 2:
Practice Address - City:THORNWOOD
Practice Address - State:NY
Practice Address - Zip Code:10594-1133
Practice Address - Country:US
Practice Address - Phone:914-769-0558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061658183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist