Healthcare Provider Details

I. General information

NPI: 1720899206
Provider Name (Legal Business Name): LI 888 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2025
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 HILLSIDE AVE
WILLISTON PARK NY
11596-2304
US

IV. Provider business mailing address

8 DELAMAR CT
GLEN COVE NY
11542-1792
US

V. Phone/Fax

Practice location:
  • Phone: 516-506-7140
  • Fax:
Mailing address:
  • Phone: 516-698-3086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: DR. RONGLAN ZHENG
Title or Position: OWNER
Credential: MD
Phone: 516-698-3086