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General NPI Number Information
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NPI Number | 1124141478
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Entity Type | Individual
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Provider Name | YONGMING LI MD, PHD, AC
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Gender | Male
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | GREEN KNOLL PROFESSIONAL PARK 720 ROUTE 202-206 NORTH STE 1C
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City | BRIDGEWATER
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State | NJ
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Zip | 08807
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Country | US
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Telephone | 908-203-0471
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Fax |
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Provider Business Mailing Address
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Address Line | 693 FOOTHILL RD
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-1874
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Country | US
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Telephone | 908-203-0471
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 25MA07422800
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License Number State | NJ
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