Individual
YAN LI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
101 COMMERCE WAY, TARGET OPTICAL, WOBURN, MA 01801-1007
(781) 904-0005
(781) 904-0007
Mailing address
31 HOULTON ST, BEDFORD, MA 01730-1901
(781) 964-3840
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4235
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0399868
—
MA
01
—
W16341
BCBS
MA
Enumeration date
09/24/2006
Last updated
07/08/2007
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