Provider Demographics
NPI:1245496686
Name:LI, HO CHEUNG (R PH)
Entity type:Individual
Prefix:
First Name:HO
Middle Name:CHEUNG
Last Name:LI
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 MERMAID AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-2208
Mailing Address - Country:US
Mailing Address - Phone:917-892-2083
Mailing Address - Fax:718-266-6386
Practice Address - Street 1:2302 MERMAID AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-2208
Practice Address - Country:US
Practice Address - Phone:917-892-2083
Practice Address - Fax:718-266-6386
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046328183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY046328OtherPHARMACIST LICENSE