Healthcare Provider Details

I. General information

NPI: 1063227981
Provider Name (Legal Business Name): MICHELLE YI LI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 02/10/2025
Certification Date: 02/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 6TH ST
BROOKLYN NY
11215-3609
US

IV. Provider business mailing address

7601 16TH AVE
BROOKLYN NY
11214-1007
US

V. Phone/Fax

Practice location:
  • Phone: 718-780-6855
  • Fax:
Mailing address:
  • Phone: 917-239-2332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number072356
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: