Provider Demographics
NPI:1659368223
Name:LI, BILLY (MD)
Entity type:Individual
Prefix:DR
First Name:BILLY
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:13 ELIZABETH ST
Mailing Address - Street 2:ROOM 301
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4803
Mailing Address - Country:US
Mailing Address - Phone:212-966-7493
Mailing Address - Fax:212-966-7495
Practice Address - Street 1:13 ELIZABETH ST
Practice Address - Street 2:ROOM 301
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4803
Practice Address - Country:US
Practice Address - Phone:212-966-7493
Practice Address - Fax:212-966-7495
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2017-01-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY230574207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02526598Medicaid
NY02526598Medicaid
NY96S051Medicare PIN