MEDICARE: MR. RUNHONG LI L.AC

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	171100000X	Acupuncturist	002333	NY

General Provider Information

NPI Number	:	1841418092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RUNHONG LI L.AC

Provider Business Mailing Address
First Line	:	2210 86TH ST
Second Line	:	2ND FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11214-4108
Country	:	US
Telephone Number	:	718-449-5086
Fax Number	:	718-449-5086

Provider Business Practice Location Address
First Line	:	2210 86TH ST
Second Line	:	2ND FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11214-4108
Country	:	US
Telephone Number	:	718-449-5086
Fax Number	:	718-449-5086

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

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	07/08/2007

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