Healthcare Provider Details

I. General information

NPI: 1174211510
Provider Name (Legal Business Name): AOBO LI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2023
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date: 11/29/2023
Reactivation Date: 08/14/2025

III. Provider practice location address

110 IRVING ST NW
WASHINGTON DC
20010-3017
US

IV. Provider business mailing address

15 S POPLAR ST UNIT 206
GLASSBORO NJ
08028-3606
US

V. Phone/Fax

Practice location:
  • Phone: 410-454-8909
  • Fax:
Mailing address:
  • Phone: 689-251-1962
  • Fax: 856-575-4944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD600005639
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: