Provider Demographics
NPI:1285095117
Name:LI, LINDA JIE (MD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:JIE
Last Name:LI
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 858
Mailing Address - Street 2:MC A410
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-0858
Mailing Address - Country:US
Mailing Address - Phone:800-243-1455
Mailing Address - Fax:
Practice Address - Street 1:35 HOPE DRIVE
Practice Address - Street 2:SUITES 202 & 204
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2086
Practice Address - Country:US
Practice Address - Phone:800-243-1455
Practice Address - Fax:717-531-4375
Is Sole Proprietor?:No
Enumeration Date:2016-03-20
Last Update Date:2020-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD471136207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1032957180001Medicaid