Provider Demographics
NPI:1467900985
Name:LI, WEIWEN (ACU)
Entity Type:Individual
Prefix:MR
First Name:WEIWEN
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:ACU
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:757 60TH ST
Mailing Address - Street 2:4 FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-4209
Mailing Address - Country:US
Mailing Address - Phone:718-717-8788
Mailing Address - Fax:347-374-4855
Practice Address - Street 1:757 60TH ST
Practice Address - Street 2:4 FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4209
Practice Address - Country:US
Practice Address - Phone:718-717-8788
Practice Address - Fax:347-374-4855
Is Sole Proprietor?:No
Enumeration Date:2016-09-13
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005739171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist