Provider Demographics
NPI:1366680712
Name:LI, WEIPING (OMD)
Entity Type:Individual
Prefix:DR
First Name:WEIPING
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07029-2547
Mailing Address - Country:US
Mailing Address - Phone:973-482-9432
Mailing Address - Fax:
Practice Address - Street 1:215 N 2ND ST
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NJ
Practice Address - Zip Code:07029-2547
Practice Address - Country:US
Practice Address - Phone:973-482-9432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00041300171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist