Healthcare Provider Details

I. General information

NPI: 1407477318
Provider Name (Legal Business Name): ANFEI LI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2020
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 YORK AVE FL 11
NEW YORK NY
10021-5663
US

IV. Provider business mailing address

100 PRESIDENTIAL BLVD STE 200
BALA CYNWYD PA
19004-1108
US

V. Phone/Fax

Practice location:
  • Phone: 646-962-2020
  • Fax:
Mailing address:
  • Phone: 484-434-2700
  • Fax: 610-660-0419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number328173
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number25MA12660300
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License NumberMD489280
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: