Provider Demographics
NPI:1073582243
Name:LI, VEETAI (MD)
Entity Type:Individual
Prefix:DR
First Name:VEETAI
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 MAIN ST FL 3
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1009
Mailing Address - Country:US
Mailing Address - Phone:716-878-7386
Mailing Address - Fax:
Practice Address - Street 1:1001 MAIN ST FL 3
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1009
Practice Address - Country:US
Practice Address - Phone:716-878-7386
Practice Address - Fax:716-878-1577
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY193028207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01440133Medicaid
NY000511958002OtherBLUE CROSS WNY
NY00010104202OtherUNIVERA
NY0605545OtherINDEPENDENT HEALTH INS
NY0605545OtherINDEPENDENT HEALTH INS
NY01440133Medicaid