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General NPI Number Information
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NPI Number | 1205503554
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Entity Type | Organization
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Legal Business Name | CONRAD LI INTERNAL MEDICINE PC
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Dates
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Enumeration Date | 08/25/2021
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 13620 MAPLE AVE # C702
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City | FLUSHING
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State | NY
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Zip | 11355-5166
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Country | US
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Telephone | 347-368-4288
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Fax | 347-368-4785
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Provider Business Mailing Address
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Address Line | 13620 MAPLE AVE # C702
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City | FLUSHING
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State | NY
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Zip | 11355-5166
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Country | US
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Telephone | 347-368-4288
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Fax | 347-368-4785
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Authorized Official
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Title or Position | CEO
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Name | CONRAD LI
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Credential | MD
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Telephone | 347-368-4288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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