Individual
JOHNNY XIANG LI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
128 MOTT ST STE 408, NEW YORK, NY 10013-5588
(212) 732-0073
Mailing address
635 W 165TH ST # 96, NEW YORK, NY 10032-3724
(212) 305-9535
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
311321
NY
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
311321
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
311321
LICENSE
NY
Enumeration date
04/03/2017
Last updated
06/02/2023
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