MEDICARE: ALL TIME CARE MEDICAL PLLC

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	207Q00000X	Family Medicine Physician	249277	NY

General Provider Information

NPI Number	:	1588934921
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL TIME CARE MEDICAL PLLC

Provider Business Mailing Address
First Line	:	679 60TH ST FL 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-4108
Country	:	US
Telephone Number	:	347-901-3407
Fax Number	:

Provider Business Practice Location Address
First Line	:	679 60TH ST FL 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-4108
Country	:	US
Telephone Number	:	347-901-3407
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	BRIAN CHENGHUI LI
Credential	:	D.O.
Telephone Number	:	347-901-3407

Provider Enumeration Date	:	01/02/2012
Last Update Date	:	03/14/2013

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