Provider Demographics
NPI:1396009379
Name:BAI, LI-JUN
Entity Type:Individual
Prefix:
First Name:LI-JUN
Middle Name:
Last Name:BAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 137TH ST
Mailing Address - Street 2:#6D
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-2053
Mailing Address - Country:US
Mailing Address - Phone:718-939-3208
Mailing Address - Fax:
Practice Address - Street 1:2909 137TH ST
Practice Address - Street 2:#6D
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-2053
Practice Address - Country:US
Practice Address - Phone:718-939-3208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist