Healthcare Provider Details

I. General information

NPI: 1871416511
Provider Name (Legal Business Name): LI YE DOULA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4367 159TH ST
FLUSHING NY
11358-3145
US

IV. Provider business mailing address

4367 159TH ST
FLUSHING NY
11358-3145
US

V. Phone/Fax

Practice location:
  • Phone: 929-376-6958
  • Fax:
Mailing address:
  • Phone: 929-376-6958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175M00000X
TaxonomyLay Midwife
License NumberJU73YL8IE
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: