Provider Demographics
NPI:1982916177
Name:LI, STEPHEN H (LIC AC)
Entity Type:Individual
Prefix:PROF
First Name:STEPHEN
Middle Name:H
Last Name:LI
Suffix:
Gender:M
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 LORING RD
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-7726
Mailing Address - Country:US
Mailing Address - Phone:603-459-4340
Mailing Address - Fax:
Practice Address - Street 1:10 HOLDEN ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-5238
Practice Address - Country:US
Practice Address - Phone:781-526-7800
Practice Address - Fax:781-321-8818
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-05
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA245793171100000X
NH185171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist