Provider Demographics
NPI:1952389355
Name:LI, JOAN (MD)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13527 38TH AVE
Mailing Address - Street 2:SUITE 398
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4406
Mailing Address - Country:US
Mailing Address - Phone:718-445-9088
Mailing Address - Fax:718-445-5348
Practice Address - Street 1:13527 38TH AVE
Practice Address - Street 2:SUITE 398
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4406
Practice Address - Country:US
Practice Address - Phone:718-445-9088
Practice Address - Fax:718-445-5348
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211916207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02204337Medicaid
NY1000031767OtherAFFINITY PROVIDER ID
NY7239372OtherAETNA PPO PROVIDER ID
NYSP14185OtherCENTERCARE PROVIDER ID
NY2104114OtherFIRST HEALTH PROVIDER ID
NY4C5053OtherHEALTHNET PROVIDER ID
NY113681295OtherMAGNACARE PROVIDER ID
NY150170301OtherHEALTHPLUS PROVIDER ID
NY211916OtherHIP PROVIDER ID
NY2891530OtherAETNA HMO PROVIDER ID
NY434B5OtherEMPIRE BCBS PROVIDER ID
NY21222849175OtherBEECH STREET PROVIDER ID
NY2165752-004OtherCIGNA PROVIDER ID
NY0402412OtherGHI PROVIDER ID
NY113681295OtherHORIZON PROVIDER ID
NY211916-A40OtherHEALTHFIST PROVIDER ID
NY113681295Other1199 PROVIDER ID
NY113681295LI01OtherCAREPLUS PROVIDER ID
NY171193OtherELDERPLAN PROVIDER ID
NY2165752-004OtherCIGNA PROVIDER ID
NY434B5OtherEMPIRE BCBS PROVIDER ID