Provider Demographics
NPI:1295939494
Name:LI, YIDING (MD)
Entity type:Individual
Prefix:DR
First Name:YIDING
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5115 7 AVE.1ST FL
Mailing Address - Street 2:1ST FL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-3254
Mailing Address - Country:US
Mailing Address - Phone:718-851-8928
Mailing Address - Fax:718-851-0618
Practice Address - Street 1:818 60TH ST UNIT C3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4311
Practice Address - Country:US
Practice Address - Phone:718-851-8928
Practice Address - Fax:718-851-0618
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY246551207Q00000X
IA35933207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03099254Medicaid
IA1295939494Medicaid
IA1295939494Medicaid
NYA400008861Medicare PIN