Provider Demographics
NPI:1952428732
Name:LI, WAYNE WINGCHIN (PT)
Entity Type:Individual
Prefix:
First Name:WAYNE
Middle Name:WINGCHIN
Last Name:LI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:22159 HORACE HARDING EXPY FL 2
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2320
Mailing Address - Country:US
Mailing Address - Phone:917-951-3953
Mailing Address - Fax:
Practice Address - Street 1:86 BOWERY STREET
Practice Address - Street 2:6 FL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4615
Practice Address - Country:US
Practice Address - Phone:212-219-9197
Practice Address - Fax:718-569-0578
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023663-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist