Provider Demographics
NPI:1659496412
Name:LI, DAVID XUHUI (LAC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:XUHUI
Last Name:LI
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:101 SHOTWELL AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-1966
Mailing Address - Country:US
Mailing Address - Phone:718-680-7777
Mailing Address - Fax:718-605-4273
Practice Address - Street 1:6203 FORT HAMILTON PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-5116
Practice Address - Country:US
Practice Address - Phone:718-680-7777
Practice Address - Fax:718-605-4273
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000721171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist