Provider Demographics
NPI:1689662132
Name:LI, ZUJUN (MD)
Entity Type:Individual
Prefix:DR
First Name:ZUJUN
Middle Name:
Last Name:LI
Suffix:
Gender:M
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:PO BOX 95000-2441
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-2441
Mailing Address - Country:US
Mailing Address - Phone:212-367-1870
Mailing Address - Fax:212-604-6038
Practice Address - Street 1:325 W 15TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-5903
Practice Address - Country:US
Practice Address - Phone:212-367-1870
Practice Address - Fax:212-604-6038
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2148901207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02317884Medicaid
NYH74672Medicare UPIN
NY5Z7511Medicare ID - Type Unspecified