Provider Demographics
NPI:1730355348
Name:LI, LING
Entity type:Individual
Prefix:
First Name:LING
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 GLEN ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-2414
Mailing Address - Country:US
Mailing Address - Phone:617-899-6316
Mailing Address - Fax:
Practice Address - Street 1:414 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-1067
Practice Address - Country:US
Practice Address - Phone:617-742-5797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-03
Last Update Date:2008-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA222748171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist