Healthcare Provider Details

I. General information

NPI: 1841376050
Provider Name (Legal Business Name): WILLIAM XILIAN LI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 02/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8268 164TH ST G24
JAMAICA NY
11432-1121
US

IV. Provider business mailing address

8268 164TH ST G24
JAMAICA NY
11432-1121
US

V. Phone/Fax

Practice location:
  • Phone: 718-883-3535
  • Fax: 718-883-6282
Mailing address:
  • Phone: 718-883-3535
  • Fax: 718-883-6282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberA212580
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: