1780831743 NPI number — WEI LI MD

Table of content: WEI LI MD (NPI 1780831743)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780831743 NPI number — WEI LI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LI
Provider First Name:
WEI
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1780831743
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/26/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3049 CLUBHOUSE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MERRICK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11566-4808
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-670-2816
Provider Business Mailing Address Fax Number:
347-532-1349

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13237 41ST RD STE C03
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLUSHING
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11355-4235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-618-1636
Provider Business Practice Location Address Fax Number:
347-532-1349
Provider Enumeration Date:
08/21/2008

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: 207R00000X , with the licence number:  100034 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: MD037812 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: D0068728 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: 256795 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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