Provider Demographics
NPI:1760235667
Name:ZHAO, LILI (PHARM D)
Entity Type:Individual
Prefix:
First Name:LILI
Middle Name:
Last Name:ZHAO
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23147 KLEINSMITH WAY
Mailing Address - Street 2:
Mailing Address - City:BRAMBLETON
Mailing Address - State:VA
Mailing Address - Zip Code:20148-7248
Mailing Address - Country:US
Mailing Address - Phone:734-604-7453
Mailing Address - Fax:
Practice Address - Street 1:3905 FAIR RIDGE DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-2906
Practice Address - Country:US
Practice Address - Phone:703-542-8304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202210274183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist