Healthcare Provider Details

I. General information

NPI: 1629275938
Provider Name (Legal Business Name): HEMATOLOGY AND ONCOLOGY OF LI PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 02/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BOUNDARY AVE SUITE 200
MASSAPEQUA NY
11758-1152
US

IV. Provider business mailing address

PO BOX 1248
SYOSSET NY
11791-0490
US

V. Phone/Fax

Practice location:
  • Phone: 516-755-2404
  • Fax: 516-755-2405
Mailing address:
  • Phone: 516-755-2404
  • Fax: 516-755-2405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NATAYLA KRICHMAR
Title or Position: DOCTOR AND OWNER
Credential: M.D.
Phone: 516-755-2404