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NPI Code Detail

MEDICARE: TYLER LI PA

MEDICARE: TYLER LI PA
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
1363A00000XPhysician Assistant034958NY

General Provider Information

NPI Number : 1366385981
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYLER LI PA
Provider Business Mailing Address
First Line : 4153 BEDFORD AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-2451
Country : US
Telephone Number : 917-362-7800
Fax Number :
Provider Business Practice Location Address
First Line : 2601 OCEAN PKWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-7745
Country : US
Telephone Number : 844-692-4692
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2026
Last Update Date : 04/09/2026

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Directions to “ TYLER LI PA” Practice Location

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