Provider Demographics
NPI:1144399916
Name:LI, HAIYANG (PHD, LAC)
Entity Type:Individual
Prefix:
First Name:HAIYANG
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:PHD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 YORK RD
Mailing Address - Street 2:
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4224
Mailing Address - Country:US
Mailing Address - Phone:410-252-1958
Mailing Address - Fax:410-252-2980
Practice Address - Street 1:1909 YORK RD
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-4224
Practice Address - Country:US
Practice Address - Phone:410-252-1958
Practice Address - Fax:410-252-2980
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU-354171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist