Healthcare Provider Details

I. General information

NPI: 1669359873
Provider Name (Legal Business Name): LL MEDICAL CLINIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 PENN PLZ
NEW YORK NY
10001-3967
US

IV. Provider business mailing address

7 PENN PLZ STE 1204
NEW YORK NY
10001-3923
US

V. Phone/Fax

Practice location:
  • Phone: 646-887-3138
  • Fax:
Mailing address:
  • Phone: 646-887-3138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SC2300X
TaxonomyChronic Care Clinical Nurse Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: ADI PATEL
Title or Position: GC
Credential:
Phone: 646-887-3138