Provider Demographics
NPI:1841361169
Name:LI, QIQING (LAC)
Entity type:Individual
Prefix:
First Name:QIQING
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7618 18TH AVE
Mailing Address - Street 2:FL 1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-1108
Mailing Address - Country:US
Mailing Address - Phone:718-621-0889
Mailing Address - Fax:
Practice Address - Street 1:7618 18TH AVE
Practice Address - Street 2:FL 1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-1108
Practice Address - Country:US
Practice Address - Phone:718-621-0889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000854171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist