Healthcare Provider Details

I. General information

NPI: 1689164832
Provider Name (Legal Business Name): PHILIPPA LI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2018
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CRANBERRY HL STE 105
LEXINGTON MA
02421-7397
US

IV. Provider business mailing address

1 CRANBERRY HL STE 303
LEXINGTON MA
02421-7397
US

V. Phone/Fax

Practice location:
  • Phone: 800-325-7284
  • Fax: 205-579-9387
Mailing address:
  • Phone: 781-290-0057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number1017784
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number1019827
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: