Provider Demographics
NPI:1053325407
Name:LI, PAUL XIAOPU (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:XIAOPU
Last Name:LI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:13336 41ST RD STE 1
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3666
Mailing Address - Country:US
Mailing Address - Phone:718-568-9538
Mailing Address - Fax:718-961-1393
Practice Address - Street 1:13336 41ST RD STE 1
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3666
Practice Address - Country:US
Practice Address - Phone:718-568-9538
Practice Address - Fax:718-961-1393
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2008-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY244809207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY56995XW321Medicare PIN