Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 041484 | CT |
NPI | 1023005667 |
---|---|
Provider Name | Dr. Ting Li |
First Address | Mystic, CT 06355-4041 |
Second Address | Norwich, CT 06360-2737 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2005 |
Last Update Date | 15/01/2022 |