Provider Demographics
NPI:1518284561
Name:LI, ZIYU (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:ZIYU
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 KENILWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-1411
Mailing Address - Country:US
Mailing Address - Phone:215-927-1205
Mailing Address - Fax:215-745-3764
Practice Address - Street 1:6401 OXFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19111-5400
Practice Address - Country:US
Practice Address - Phone:215-745-2557
Practice Address - Fax:215-745-3764
Is Sole Proprietor?:No
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP443710183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist