Healthcare Provider Details

I. General information

NPI: 1689662132
Provider Name (Legal Business Name): ZUJUN LI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 W 15TH ST
NEW YORK NY
10011-5903
US

IV. Provider business mailing address

PO BOX 95000-2441
PHILADELPHIA PA
19195-2441
US

V. Phone/Fax

Practice location:
  • Phone: 212-367-1870
  • Fax: 212-604-6038
Mailing address:
  • Phone: 212-367-1870
  • Fax: 212-604-6038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number2148901
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: