Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 214402 | NY |
NPI | 1013007814 |
---|---|
Provider Name | Peng Li |
First Address | Bronx, NY 10469-5647 |
Second Address | Bronx, NY 10468 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 08/07/2007 |