Healthcare Provider Details

I. General information

NPI: 1134534829
Provider Name (Legal Business Name): HSIN TING LI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2014
Last Update Date: 01/26/2023
Certification Date: 01/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 S BEDFORD RD
MOUNT KISCO NY
10549-5402
US

IV. Provider business mailing address

512 BEDFORD RD
MOUNT KISCO NY
10549-4520
US

V. Phone/Fax

Practice location:
  • Phone: 914-244-6789
  • Fax:
Mailing address:
  • Phone: 929-300-2402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number292442-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: