Healthcare Provider Details

I. General information

NPI: 1154826915
Provider Name (Legal Business Name): YUN R LI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2018
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 E. ADAMS. ST 3RD FLR
SYRACUSE NY
13210
US

IV. Provider business mailing address

725 E. ADAMS. ST 3RD FLR
SYRACUSE NY
13210
US

V. Phone/Fax

Practice location:
  • Phone: 315-464-5240
  • Fax: 315-464-3751
Mailing address:
  • Phone: 315-464-5240
  • Fax: 315-464-3751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number287396
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number344660
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: