Individual
QIU CI LI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
300A FAUNCE CORNER RD, NORTH DARTMOUTH, MA 02747-1280
(508) 973-1140
(508) 973-1145
Mailing address
200 MILL RD STE 180, FAIRHAVEN, MA 02719-5255
(508) 973-2000
(508) 973-2001
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
S80674161
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3HZN21427880
—
MA
Enumeration date
08/07/2012
Last updated
04/22/2020
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