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NPI Code Detail

MEDICARE: CONGCONG LI FNP

MEDICARE: CONGCONG LI FNP
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
1163W00000XRegistered Nurse773278NY
2363LF0000XFamily Nurse PractitionerF351007NY

General Provider Information

NPI Number : 1760086441
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONGCONG LI FNP
Provider Business Mailing Address
First Line : 837 59TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-5576
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 837 59TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-5576
Country : US
Telephone Number : 718-975-8415
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2020
Last Update Date : 01/27/2023

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Directions to “ CONGCONG LI FNP” Practice Location

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