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General NPI Number Information
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NPI Number | 1881078558
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Entity Type | Individual
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Provider Name | I-LI LEI NP
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Gender | Female
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Dates
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Enumeration Date | 07/13/2015
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Last Update Date | 08/16/2017
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Provider Practice Location Address
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Address Line | 3959 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10032-1559
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Country | US
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Telephone | 646-426-2952
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Fax |
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Provider Business Mailing Address
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Address Line | 13919 31ST RD APT 1F
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City | FLUSHING
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State | NY
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Zip | 11354-2111
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Country | US
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Telephone | 917-703-0993
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F340326-1
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License Number State | NY
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