Provider Demographics
NPI:1649748443
Name:LIU, ALEXANDER ZHONGZHENG (DACM)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:ZHONGZHENG
Last Name:LIU
Suffix:
Gender:M
Credentials:DACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 MONTANA ST
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-2413
Mailing Address - Country:US
Mailing Address - Phone:813-464-5509
Mailing Address - Fax:
Practice Address - Street 1:19 MONTANA ST
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-2413
Practice Address - Country:US
Practice Address - Phone:813-464-5509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-09
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006139171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist