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General NPI Number Information
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NPI Number | 1629275938
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Entity Type | Organization
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Legal Business Name | HEMATOLOGY AND ONCOLOGY OF LI PLLC
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 02/28/2013
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Provider Practice Location Address
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Address Line | 200 BOUNDARY AVE SUITE 200
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City | MASSAPEQUA
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State | NY
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Zip | 11758-1152
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Country | US
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Telephone | 516-755-2404
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Fax | 516-755-2405
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Provider Business Mailing Address
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Address Line | PO BOX 1248
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City | SYOSSET
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State | NY
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Zip | 11791-0490
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Country | US
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Telephone | 516-755-2404
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Fax | 516-755-2405
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Authorized Official
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Title or Position | DOCTOR AND OWNER
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Name | DR. NATAYLA KRICHMAR
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Credential | M.D.
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Telephone | 516-755-2404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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