Healthcare Provider Details

I. General information

NPI: 1760487581
Provider Name (Legal Business Name): HENRY HOWARD LIM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 BELLMORE AVE # A
EAST MEADOW NY
11554-4710
US

IV. Provider business mailing address

516 BELLMORE AVE
EAST MEADOW NY
11554-4710
US

V. Phone/Fax

Practice location:
  • Phone: 516-489-8455
  • Fax: 516-489-8433
Mailing address:
  • Phone: 516-489-8455
  • Fax: 516-489-8433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number222299
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: