MEDICARE: DR. PAUL XIAOPU LI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	244809	NY

General Provider Information

NPI Number	:	1053325407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL XIAOPU LI MD

Provider Business Mailing Address
First Line	:	13336 41ST RD STE 1
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11355-3666
Country	:	US
Telephone Number	:	718-568-9538
Fax Number	:	718-961-1393

Provider Business Practice Location Address
First Line	:	13336 41ST RD STE 1
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11355-3666
Country	:	US
Telephone Number	:	718-568-9538
Fax Number	:	718-961-1393

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	07/12/2008

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