Provider Demographics
NPI:1427227438
Name:NI, LILI (LICACUP)
Entity Type:Individual
Prefix:MISS
First Name:LILI
Middle Name:
Last Name:NI
Suffix:
Gender:F
Credentials:LICACUP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6411 99TH ST APT 219
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2640
Mailing Address - Country:US
Mailing Address - Phone:718-275-3721
Mailing Address - Fax:
Practice Address - Street 1:6411 99TH ST APT 219
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2640
Practice Address - Country:US
Practice Address - Phone:718-275-3721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-23
Last Update Date:2008-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2677171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2677OtherACUPUNCTURE LICENCE