Provider Demographics
NPI:1558063404
Name:LI, SHUHAN (MD)
Entity Type:Individual
Prefix:
First Name:SHUHAN
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 1:300 MANHASSET AVE
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-2259
Mailing Address - Country:US
Mailing Address - Phone:516-562-3047
Mailing Address - Fax:516-562-3569
Practice Address - Street 1:300 MANHASSET AVE
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-2259
Practice Address - Country:US
Practice Address - Phone:516-562-3047
Practice Address - Fax:516-562-3569
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program