Provider Demographics
NPI:1699904151
Name:LI, BRIAN CHENGHUI (DO)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:CHENGHUI
Last Name:LI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:679 60TH STREET 1ST FLOOR
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-4108
Mailing Address - Country:US
Mailing Address - Phone:718-567-8910
Mailing Address - Fax:
Practice Address - Street 1:679 60TH STREET 1ST FLOOR
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4108
Practice Address - Country:US
Practice Address - Phone:718-567-8910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249277-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine