1659340420 NPI number — WEIYE LI M.D.

Table of content: WEIYE LI M.D. (NPI 1659340420)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659340420 NPI number — WEIYE LI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LI
Provider First Name:
WEIYE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659340420
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/12/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1740 SOUTH ST STE 400
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19146-1514
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
267-607-6888
Provider Business Mailing Address Fax Number:
267-393-4310

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1740 SOUTH ST STE 400
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19146-1514
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
267-607-6888
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  MD420302 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10729 . This is a "ELDER HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1466302 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 21505410000 . This is a "KEYSTONE INDIVIDULE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: X002529001 . This is a "AMERICHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3143519 . This is a "AETNA US HEALTHCARE INDIV" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 7001998 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 300107760 . This is a "KEYSTONE MERCY HEALTH PLA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1008200730003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: A19503 . This is a "AMERIHEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0794182000 . This is a "KEYSTONE GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1000033580 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1466302 . This is a "DELAWARE BLUE CROSS BLUE" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 31188 . This is a "AETNA US HEALTHCARE GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 37992 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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