Provider Demographics
NPI:1235329962
Name:ELSA S. LI, M.D. P.C.
Entity Type:Organization
Organization Name:ELSA S. LI, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELSA
Authorized Official - Middle Name:S
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-393-7807
Mailing Address - Street 1:112 MAIN STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NORTHBORO
Mailing Address - State:MA
Mailing Address - Zip Code:01532
Mailing Address - Country:US
Mailing Address - Phone:508-393-7807
Mailing Address - Fax:508-393-8608
Practice Address - Street 1:112 MAIN STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:NORTHBORO
Practice Address - State:MA
Practice Address - Zip Code:01532
Practice Address - Country:US
Practice Address - Phone:508-393-7807
Practice Address - Fax:508-393-8608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty