Healthcare Provider Details

I. General information

NPI: 1144569377
Provider Name (Legal Business Name): RAN LI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2013
Last Update Date: 05/24/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N BELLEFIELD AVE 4TH FLOOR
PITTSBURGH PA
15213-2600
US

IV. Provider business mailing address

100 N BELLEFIELD AVE 4TH FLOOR
PITTSBURGH PA
15213-2600
US

V. Phone/Fax

Practice location:
  • Phone: 412-624-2100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD467436
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: