Individual
IVAN STEVEN LIU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 MIRRIELEES RD, GREAT NECK, NY 11021-2927
(516) 582-0722
Mailing address
1 MIRRIELEES RD, GREAT NECK, NY 11021-2927
(516) 582-0722
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
008526
NY
Other
Enumeration date
12/02/2019
Last updated
12/02/2019
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