Individual
JIAO LI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1209 WAVE AVE, MEDFORD, NY 11763-1753
(631) 605-9307
Mailing address
1209 WAVE AVE, MEDFORD, NY 11763-1753
(631) 605-9307
Taxonomy
Speciality
Code
Description
License number
State
163WX0200X
Oncology Registered Nurse
Primary
677613
NY
Other
Enumeration date
11/04/2025
Last updated
11/04/2025
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