Provider Demographics
NPI:1962870881
Name:LIANG, WEIQUAN
Entity type:Individual
Prefix:
First Name:WEIQUAN
Middle Name:
Last Name:LIANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4122 PARSONS BLVD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-1914
Mailing Address - Country:US
Mailing Address - Phone:718-888-7711
Mailing Address - Fax:
Practice Address - Street 1:41-21 PARSONS BOULEVARD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-3419
Practice Address - Country:US
Practice Address - Phone:718-445-7715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-09
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060477183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist