Provider Demographics
NPI:1063975928
Name:LI, WEIXIN ADEN (RPH)
Entity type:Individual
Prefix:MR
First Name:WEIXIN
Middle Name:ADEN
Last Name:LI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6121 BELL BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2239
Mailing Address - Country:US
Mailing Address - Phone:917-539-5188
Mailing Address - Fax:
Practice Address - Street 1:13532 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5339
Practice Address - Country:US
Practice Address - Phone:718-359-5605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-08
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY067821183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist