Provider Demographics
NPI:1336402395
Name:LI, YUN
Entity Type:Individual
Prefix:MRS
First Name:YUN
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6730 DARTMOUTH ST
Mailing Address - Street 2:APT. 2T
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4057
Mailing Address - Country:US
Mailing Address - Phone:718-459-4358
Mailing Address - Fax:
Practice Address - Street 1:6730 DARTMOUTH ST
Practice Address - Street 2:APT. 2T
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4057
Practice Address - Country:US
Practice Address - Phone:718-459-4358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-24
Last Update Date:2012-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001610171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist