Healthcare Provider Details

I. General information

NPI: 1013627934
Provider Name (Legal Business Name): LI INFECTIOUS DISEASE MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2022
Last Update Date: 12/01/2022
Certification Date: 12/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 MAIN PKWY E
PLAINVIEW NY
11803-2018
US

IV. Provider business mailing address

65 MAIN PKWY E
PLAINVIEW NY
11803-2018
US

V. Phone/Fax

Practice location:
  • Phone: 631-271-9151
  • Fax: 631-271-9155
Mailing address:
  • Phone: 631-271-9151
  • Fax: 631-271-9155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier240664
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerNYS LICENSE

VIII. Authorized Official

Name: LENNY WEINSTEIN
Title or Position: OWNER
Credential: DO
Phone: 917-693-0812