Individual
MRS. KATIE JIAJIA LI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6123 136TH ST FL 1, FLUSHING, NY 11367-1038
(646) 625-9839
Mailing address
2510 30TH AVE, ASTORIA, NY 11102-2448
(718) 932-1000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
018072-1
NY
Other
Enumeration date
10/07/2014
Last updated
03/22/2021
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