Basic Information
| Provider Information | |||||||||
| NPI: | 1023062429 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LIU AND ASSOCIATES FAMILY MEDICINE, LLC | ||||||||
| LastName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | ELLSWEIG & LIU, MDS, LLC | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1650 VALLEY CENTER PKWY | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180172344 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4848844436 | ||||||||
| FaxNumber: | 4848844444 | ||||||||
| Practice Location | |||||||||
| Address1: | 1251 S CEDAR CREST BLVD | ||||||||
| Address2: | SUITE 102A | ||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181036205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6107760377 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2006 | ||||||||
| LastUpdateDate: | 09/02/2008 | ||||||||
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| AuthorizedOfficialLastName: | LIU | ||||||||
| AuthorizedOfficialFirstName: | HENRY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6407760377 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1411554 | 01 | PA | AMERIHEALTH ADMIN | OTHER | 2098706001 | 01 | PA | INDEPENDENCE BLUE CROSS | OTHER | 50004295 | 01 | PA | AMERIHEALTH MERCY | OTHER | E1BZ | 01 | PA | GEISINGER HEALTH PLAN | OTHER | 01915633 | 05 | PA | MEDICAID | 7693201001 | 01 | PA | CIGNA | OTHER | 1411554 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER |