Provider Demographics
NPI:1750353777
Name:TSAI, LI C (MD)
Entity type:Individual
Prefix:DR
First Name:LI
Middle Name:C
Last Name:TSAI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:P.O. BOX 191
Mailing Address - Street 2:PROVIDER ENROLLMENT DEPARTMENT
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19732-0191
Mailing Address - Country:US
Mailing Address - Phone:302-651-6212
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:100 CAMPUS DR BLDG A
Practice Address - Street 2:NEMOURS DUPONT PEDIATRICS, COLLEGEVILLE
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-3937
Practice Address - Country:US
Practice Address - Phone:484-565-8480
Practice Address - Fax:610-487-7942
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD053394L208000000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001482414Medicaid
PA232359401OtherMAIN LINE HEALTHCARE
PA232359401OtherMAIN LINE HEALTHCARE
PA188279HK1Medicare PIN