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General NPI Number Information
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NPI Number | 1376059535
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Entity Type | Individual
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Provider Name | DR. LI MA
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Gender | Female
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Dates
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Enumeration Date | 12/22/2017
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Last Update Date | 09/24/2018
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Provider Practice Location Address
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Address Line | 18 E 183RD ST
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City | BRONX
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State | NY
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Zip | 10453-1241
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Country | US
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Telephone | 718-841-9969
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Fax | 718-450-8457
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Provider Business Mailing Address
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Address Line | 2040 MONROE AVE APT 2
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City | ROCHESTER
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State | NY
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Zip | 14618-2031
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Country | US
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Telephone | 585-766-3959
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 63635
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License Number State | NY
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