Provider Demographics
NPI:1942795067
Name:LI, NINA (OD)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 CEI DR
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-5664
Mailing Address - Country:US
Mailing Address - Phone:513-569-3741
Mailing Address - Fax:
Practice Address - Street 1:222 PIEDMONT AVE STE 4000
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-4239
Practice Address - Country:US
Practice Address - Phone:513-984-5133
Practice Address - Fax:513-984-4240
Is Sole Proprietor?:No
Enumeration Date:2018-07-01
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOPT.006690152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist