Provider Demographics
NPI:1215372412
Name:LIU, MINLIN (LAC)
Entity type:Individual
Prefix:
First Name:MINLIN
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 W 72ND ST FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-3240
Mailing Address - Country:US
Mailing Address - Phone:917-447-6650
Mailing Address - Fax:516-466-3951
Practice Address - Street 1:3927 BELL BLVD STE 207
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2060
Practice Address - Country:US
Practice Address - Phone:718-912-4018
Practice Address - Fax:516-466-3951
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171100000X
NY004247171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty