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General NPI Number Information
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NPI Number | 1962895425
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Entity Type | Individual
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Provider Name | CHANEL LI DO
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Gender | Female
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Dates
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Enumeration Date | 03/09/2015
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 60B MOTT ST
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City | NEW YORK
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State | NY
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Zip | 10013-4811
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Country | US
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Telephone | 212-796-2196
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Fax | 212-795-2195
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Provider Business Mailing Address
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Address Line | 60B MOTT ST
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City | NEW YORK
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State | NY
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Zip | 10013-4811
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Country | US
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Telephone | 212-796-2196
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Fax | 212-796-2195
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 293356
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License Number State | NY
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