Individual
JOANNA LIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D., M.S.
Contact information
Practice address
4738 BROADWAY, NEW YORK, NY 10040-1103
(646) 661-7615
Mailing address
4738 BROADWAY, NEW YORK, NY 10040-1103
(646) 661-7615
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
009764
NY
Other
Enumeration date
04/04/2023
Last updated
12/13/2023
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