Provider Demographics
NPI:1437137528
Name:LI, YALI (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:YALI
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:YALI
Other - Middle Name:
Other - Last Name:LI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:8 DELAMAR CT
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-1792
Mailing Address - Country:US
Mailing Address - Phone:631-360-7380
Mailing Address - Fax:
Practice Address - Street 1:2375 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-4258
Practice Address - Country:US
Practice Address - Phone:631-549-8120
Practice Address - Fax:631-549-7019
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001354171100000X
NY228399174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02404828Medicaid
NY08280GMedicare PIN
NY02404828Medicaid
NY0390JER911Medicare PIN