Individual
FANNIE LI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
374 STOCKHOLM ST, BROOKLYN, NY 11237-4006
(718) 963-7272
Mailing address
374 STOCKHOLM ST, BROOKLYN, NY 11237-4006
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
12/19/2019
Last updated
07/19/2021
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