Provider Demographics
NPI:1740406206
Name:LIANG, ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:LIANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:39-16 PRINCE STREET
Mailing Address - Street 2:UNIT 355
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5361
Mailing Address - Country:US
Mailing Address - Phone:718-886-6882
Mailing Address - Fax:718-886-7883
Practice Address - Street 1:39-16 PRINCE STREET
Practice Address - Street 2:UNIT 355
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5361
Practice Address - Country:US
Practice Address - Phone:718-886-6882
Practice Address - Fax:718-886-7883
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RILP00977207R00000X
NY261224207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03381573Medicaid