Healthcare Provider Details

I. General information

NPI: 1265241558
Provider Name (Legal Business Name): DAVID XIANGYU LI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2025
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VB 360A, 3500 VICTORIA ST.
PITTSBURGH PA
15261
US

IV. Provider business mailing address

2540C WHARTON ST
PITTSBURGH PA
15203-5104
US

V. Phone/Fax

Practice location:
  • Phone: 888-747-0794
  • Fax:
Mailing address:
  • Phone: 484-437-8066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN794782
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: