MEDICARE: QIAO XIAN LI

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	183500000X	Pharmacist	066209	NY

General Provider Information

NPI Number	:	1447892310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QIAO XIAN LI

Provider Business Mailing Address
First Line	:	2115 67TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-4731
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1918 86TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-3104
Country	:	US
Telephone Number	:	646-490-4920
Fax Number	:

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

Provider Enumeration Date	:	10/11/2019
Last Update Date	:	02/05/2024

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Directions to “ QIAO XIAN LI ” Practice Location

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