Provider Demographics
NPI:1871564971
Name:LI, QILI (MD)
Entity type:Individual
Prefix:DR
First Name:QILI
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 1:136-20 38TH AVENUE
Mailing Address - Street 2:SUITE# 5E
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354
Mailing Address - Country:US
Mailing Address - Phone:718-359-5868
Mailing Address - Fax:718-359-5875
Practice Address - Street 1:136-20 38TH AVENUE
Practice Address - Street 2:SUITE# 5E
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354
Practice Address - Country:US
Practice Address - Phone:718-359-5868
Practice Address - Fax:718-359-5875
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207552-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02078086Medicaid
NYH20010Medicare UPIN
NY02078086Medicaid