MEDICARE: DR. HERBERT H LI DDS

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
1	1223G0001X	General Practice Dentistry	043097	NY

General Provider Information

NPI Number	:	1215069554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HERBERT H LI DDS

Provider Business Mailing Address
First Line	:	11 E BROADWAY
Second Line	:	13TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10038-1013
Country	:	US
Telephone Number	:	212-227-3088
Fax Number	:	212-227-3866

Provider Business Practice Location Address
First Line	:	11 E BROADWAY
Second Line	:	13TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10038-1013
Country	:	US
Telephone Number	:	212-227-3088
Fax Number	:	212-227-3866

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	07/18/2016

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