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NPI Code Detail

MEDICARE: TIFFANY LI

MEDICARE: TIFFANY LI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist068325NY

General Provider Information

NPI Number : 1245992775
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY LI
Provider Business Mailing Address
First Line : 4702 5TH ST
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11101-5411
Country : US
Telephone Number : 718-472-3600
Fax Number :
Provider Business Practice Location Address
First Line : 4702 5TH ST
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11101-5411
Country : US
Telephone Number : 718-472-3600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2021
Last Update Date : 10/12/2021

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Directions to “ TIFFANY LI ” Practice Location

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