Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | 2488371 | NY |
Y | 207KA0200X | Allergist | 25MA09015100 | NJ |
NPI | 1720246465 |
---|---|
Provider Name | Wei Wei Li |
First Address | Edgewater, NJ 07020-1171 |
Second Address | Edgewater, NJ 07020-1171 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2008 |
Last Update Date | 04/04/2017 |