Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 252961 | NY |
N | 208600000X | Surgeon | 252961 | NY |
Y | 2086S0129X | Vascular Surgeon | 252961 | NY |
NPI | 1023206943 |
---|---|
Provider Name | Xin Yun Li |
First Address | Staten Island, NY 10310-1664 |
Second Address | Staten Island, NY 10310-1664 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2007 |
Last Update Date | 21/11/2013 |