Provider Demographics
NPI:1780831743
Name:LI, WEI (MD)
Entity Type:Individual
Prefix:
First Name:WEI
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3049 CLUBHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-4808
Mailing Address - Country:US
Mailing Address - Phone:516-670-2816
Mailing Address - Fax:347-532-1349
Practice Address - Street 1:13237 41ST RD STE C03
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-4235
Practice Address - Country:US
Practice Address - Phone:347-618-1636
Practice Address - Fax:347-532-1349
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-21
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL100034207R00000X
DCMD037812207RC0000X
MDD0068728207RC0000X
NY256795207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine