Basic Information
| Provider Information | |||||||||
| NPI: | 1508894874 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LI | ||||||||
| FirstName: | SHARON | ||||||||
| MiddleName: | MEI MEI | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 DIAMOND HILL RD | ||||||||
| Address2: | |||||||||
| City: | BERKELEY HEIGHTS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079222104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9082734300 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1515 BROAD ST STE B120 | ||||||||
| Address2: | |||||||||
| City: | BLOOMFIELD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070033059 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9738737000 | ||||||||
| FaxNumber: | 9737438943 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2006 | ||||||||
| LastUpdateDate: | 03/09/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 25MA07094700 | NJ | Y | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 3S6732 | 01 | NJ | EMPIRE BCBS (WAYNE) | OTHER | ZD0093 | 01 | NJ | HEALTHNET | OTHER | 398244 | 01 | NJ | WELLCARE | OTHER | 7616106 | 01 | NJ | AETNA PPO# | OTHER | 2068142000 | 01 | NJ | AMERIHEALTH ID# | OTHER | 3S6731 | 01 | NJ | EMPIRE BCBS (CLIFTON) | OTHER | 1099457 | 01 | NJ | GHI PPO | OTHER | 340019417 | 01 | NJ | RAILROAD MEDICARE ID# | OTHER | 2356164 | 01 | NJ | AETNA HMO# | OTHER | P2183798 | 01 | NJ | OXFORD ID# | OTHER |