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NPI Code Detail

MEDICARE: OCEAN VIEW COMPLETE MEDICAL PC

MEDICARE: OCEAN VIEW COMPLETE MEDICAL PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist247552-1NY

General Provider Information

NPI Number : 1033472766
Entity Type Code : Organization
Provider Name (Legal Business Name) : OCEAN VIEW COMPLETE MEDICAL PC
Provider Business Mailing Address
First Line : 3001 BRIGHTON 1ST ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-8008
Country : US
Telephone Number : 718-368-0100
Fax Number : 718-368-1208
Provider Business Practice Location Address
First Line : 3001 BRIGHTON 1ST ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-8008
Country : US
Telephone Number : 718-368-0100
Fax Number : 718-368-1208
Authorized Official
Title or Position : OWNER
Name : DR. LIYE LI
Credential : M.D.
Telephone Number : 718-368-0100
Provider Enumeration Date : 06/18/2012
Last Update Date : 06/18/2012

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Directions to “OCEAN VIEW COMPLETE MEDICAL PC ” Practice Location

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