Provider Demographics
NPI:1306160544
Name:LIU, HONGBIAO (MD, PHD)
Entity type:Individual
Prefix:
First Name:HONGBIAO
Middle Name:
Last Name:LIU
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 BUFFALO AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14303-1200
Mailing Address - Country:US
Mailing Address - Phone:716-204-7458
Mailing Address - Fax:716-204-5673
Practice Address - Street 1:151 BUFFALO AVE STE 206
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14303-1200
Practice Address - Country:US
Practice Address - Phone:716-204-7458
Practice Address - Fax:716-204-5673
Is Sole Proprietor?:No
Enumeration Date:2010-03-17
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255538208D00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY255538OtherLICENSE