Provider Demographics
NPI:1316079577
Name:LITTLE TSINGTAO MEDICAL P.C.
Entity type:Organization
Organization Name:LITTLE TSINGTAO MEDICAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JI-QING
Authorized Official - Middle Name:
Authorized Official - Last Name:WEI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-353-7626
Mailing Address - Street 1:13338 41ST ROAD
Mailing Address - Street 2:2Q
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355
Mailing Address - Country:US
Mailing Address - Phone:718-353-7626
Mailing Address - Fax:718-353-7625
Practice Address - Street 1:13338 41ST ROAD
Practice Address - Street 2:2Q
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-353-7626
Practice Address - Fax:718-353-7625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY240769208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty