Basic Information
Provider Information
NPI: 1174670699
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LI
FirstName: NAIXI
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 WESTCHESTER AVE
Address2: SUITE S-614
City: RYE BROOK
State: NY
PostalCode: 105731354
CountryCode: US
TelephoneNumber: 9144285454
FaxNumber: 9144285460
Practice Location
Address1: 55 PALMER AVE
Address2:  
City: BRONXVILLE
State: NY
PostalCode: 107083403
CountryCode: US
TelephoneNumber: 9147871000
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/05/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X60219749NYY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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