Provider Demographics
NPI:1225614878
Name:LI, NORMAN (DPM)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MOUNT BETHEL RD # 209
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5603
Mailing Address - Country:US
Mailing Address - Phone:908-605-0799
Mailing Address - Fax:908-450-1558
Practice Address - Street 1:9 MOUNT BETHEL RD # 209
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5603
Practice Address - Country:US
Practice Address - Phone:908-605-0799
Practice Address - Fax:908-450-1558
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MD00379100213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program