Provider Demographics
NPI:1932224862
Name:WU, LIYING (LIC AC)
Entity Type:Individual
Prefix:
First Name:LIYING
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-2837
Mailing Address - Country:US
Mailing Address - Phone:781-329-6559
Mailing Address - Fax:
Practice Address - Street 1:484 HIGH ST
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-2837
Practice Address - Country:US
Practice Address - Phone:781-329-6559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA428171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist