| Wisdom Medical P.c. | |
|
13625 Maple Ave Suite201 Flushing NY 11355-3870 | |
| (718) 939-2669 | |
| (718) 939-2663 |
| Full Name | Wisdom Medical P.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 13625 Maple Ave, Flushing, New York |
| Authorized Official Name and Position | Lisen Liu (OWNER) |
| Authorized Official Contact | 7189392669 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wisdom Medical P.c. 13625 Maple Ave Suite201 Flushing NY 11355-3870 Ph: (718) 939-2669 | Wisdom Medical P.c. 13625 Maple Ave Suite201 Flushing NY 11355-3870 Ph: (718) 939-2669 |
| NPI Number | 1871612044 |
|---|---|
| Provider Enumeration Date | 03/28/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5395849178 |
|---|---|
| Medicare Enrollment ID | O20070404000141 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871612044 | NPI | - | NPPES |
| 02818487 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 239854 (New York) | Primary |
| Provider Name | Lisen Liu |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1265445894 PECOS PAC ID: 9931107240 Enrollment ID: I20061121000414 |
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