MEDICARE: DR. LUKE ZHAO LI MD

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	207RH0003X	Hematology & Oncology Physician	345139	NY

General Provider Information

NPI Number	:	1568090652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUKE ZHAO LI MD

Provider Business Mailing Address
First Line	:	100 NICOLLS RD
Second Line	:	HSC-15 RM 040
City	:	STONY BROOK
State	:	NY
Zip	:	11794-8191
Country	:	US
Telephone Number	:	631-444-3557
Fax Number	:	631-865-4052

Provider Business Practice Location Address
First Line	:	1 LAUTERBUR DR
Second Line	:
City	:	STONY BROOK
State	:	NY
Zip	:	11794-8191
Country	:	US
Telephone Number	:	631-444-4392
Fax Number	:

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

Provider Enumeration Date	:	04/01/2020
Last Update Date	:	06/23/2026

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