Provider Demographics
NPI:1417400763
Name:LI, MONICA KA YI (MD)
Entity Type:Individual
Prefix:DR
First Name:MONICA KA YI
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-6794
Mailing Address - Country:US
Mailing Address - Phone:757-437-8900
Mailing Address - Fax:757-437-8200
Practice Address - Street 1:125 MARKET ST
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6794
Practice Address - Country:US
Practice Address - Phone:757-437-8900
Practice Address - Fax:757-437-8200
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101259610207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology