Provider Demographics
NPI:1548295231
Name:LI, FUHAI (MD)
Entity type:Individual
Prefix:
First Name:FUHAI
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18337-1304
Mailing Address - Country:US
Mailing Address - Phone:570-296-8494
Mailing Address - Fax:570-296-8493
Practice Address - Street 1:200 3RD ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:PA
Practice Address - Zip Code:18337-1304
Practice Address - Country:US
Practice Address - Phone:570-296-8494
Practice Address - Fax:570-296-8493
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4289632084N0400X, 2084P2900X, 2084D0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
No2084D0003XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyDiagnostic Neuroimaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102216PUMMedicare ID - Type Unspecified
PAI55451Medicare UPIN