MEDICARE: XIANG YI 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	171100000X	Acupuncturist	005462	NY

General Provider Information

NPI Number	:	1891158507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	XIANG YI LI

Provider Business Mailing Address
First Line	:	6610 17TH AVE
Second Line	:	STORE
City	:	BROOKLYN
State	:	NY
Zip	:	11204-4355
Country	:	US
Telephone Number	:	347-663-0273
Fax Number	:	718-228-3895

Provider Business Practice Location Address
First Line	:	6610 17TH AVE
Second Line	:	STORE
City	:	BROOKLYN
State	:	NY
Zip	:	11204-4355
Country	:	US
Telephone Number	:	347-663-0273
Fax Number	:	718-228-3895

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

Provider Enumeration Date	:	03/30/2016
Last Update Date	:	03/30/2016

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Directions to “ XIANG YI LI ” Practice Location

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