Provider Demographics
NPI:1710614276
Name:LI, XIAOFENG (MD)
Entity Type:Individual
Prefix:PROF
First Name:XIAOFENG
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 1:11020 71ST RD APT 301
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4905
Mailing Address - Country:US
Mailing Address - Phone:212-753-9286
Mailing Address - Fax:
Practice Address - Street 1:11020 71ST RD APT 301
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4905
Practice Address - Country:US
Practice Address - Phone:212-753-9286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY293181207Q00000X, 207UN0902X, 207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy