Provider Demographics
NPI:1851947345
Name:ZHU, LI
Entity Type:Individual
Prefix:
First Name:LI
Middle Name:
Last Name:ZHU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 5TH AVE APT 40C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5045
Mailing Address - Country:US
Mailing Address - Phone:917-478-4215
Mailing Address - Fax:
Practice Address - Street 1:325 5TH AVE APT 40C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5045
Practice Address - Country:US
Practice Address - Phone:917-478-4215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-12
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY48655011174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist