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General NPI Number Information
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NPI Number | 1265751002
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Entity Type | Individual
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Provider Name | SIMON LI MD
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Gender | Male
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Dates
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Enumeration Date | 05/19/2010
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Last Update Date | 08/30/2018
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Provider Practice Location Address
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Address Line | 8510 19TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11214
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Country | US
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Telephone | 347-562-3285
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Fax | 718-232-8808
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Provider Business Mailing Address
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Address Line | 8510 19TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11214
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Country | US
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Telephone | 347-562-3285
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Fax | 718-232-8808
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 273720
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License Number State | NY
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