Provider Demographics
NPI:1902216641
Name:LI, ROLAND (MD)
Entity Type:Individual
Prefix:
First Name:ROLAND
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:121 A WEST 20TH STREET
Mailing Address - Street 2:SUITE LOWER LEVEL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011
Mailing Address - Country:US
Mailing Address - Phone:212-505-6663
Mailing Address - Fax:212-505-9542
Practice Address - Street 1:121 A WEST 20TH STREET
Practice Address - Street 2:SUITE LOWER LEVEL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011
Practice Address - Country:US
Practice Address - Phone:212-505-6663
Practice Address - Fax:212-505-9542
Is Sole Proprietor?:No
Enumeration Date:2014-05-03
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY289146207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine