Provider Demographics
NPI:1427093624
Name:LI, VINCENT WEI-TSIN (MD)
Entity type:Individual
Prefix:PROF
First Name:VINCENT
Middle Name:WEI-TSIN
Last Name:LI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:221 LONGWOOD AVE
Mailing Address - Street 2:BWH DEPT OF DERMATOLOGY
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5804
Mailing Address - Country:US
Mailing Address - Phone:617-308-9693
Mailing Address - Fax:617-582-6060
Practice Address - Street 1:221 LONGWOOD AVE
Practice Address - Street 2:BWH DEPT OF DERMATOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5804
Practice Address - Country:US
Practice Address - Phone:617-308-9693
Practice Address - Fax:617-582-6060
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA157487207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology