Provider Demographics
NPI:1366729022
Name:LI, LIVIA (DPT)
Entity type:Individual
Prefix:DR
First Name:LIVIA
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:LIVIA
Other - Middle Name:
Other - Last Name:YUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:815 2ND AVE STE 701
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-4503
Mailing Address - Country:US
Mailing Address - Phone:212-499-0876
Mailing Address - Fax:212-499-0753
Practice Address - Street 1:815 2ND AVE STE 701
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017
Practice Address - Country:US
Practice Address - Phone:212-499-0876
Practice Address - Fax:212-499-0753
Is Sole Proprietor?:No
Enumeration Date:2011-11-09
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
NY0342601225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist