Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 31375 | NY |
NPI | 1003060120 |
---|---|
Provider Name | Qing Evelyn Li |
First Address | Flushing, NY 11354-4346 |
Second Address | Flushing, NY 11354-4247 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2008 |
Last Update Date | 19/02/2013 |