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General NPI Number Information
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NPI Number | 1659805869
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Entity Type | Organization
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Legal Business Name | LIN LI, M.D., P.A.
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Dates
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Enumeration Date | 04/13/2017
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Last Update Date | 09/26/2017
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Provider Practice Location Address
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Address Line | 1303 STATE ROUTE 27 SUITE 5
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City | SOMERSET
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State | NJ
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Zip | 08873-3456
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Country | US
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Telephone | 732-246-1932
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Fax | 732-246-1936
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Provider Business Mailing Address
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Address Line | 15 DOLORES DR
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City | EDISON
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State | NJ
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Zip | 08817-2328
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Country | US
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Telephone | 732-246-1932
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Fax | 732-246-1936
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LIN LI
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Credential | M.D
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Telephone | 585-315-2433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 25MA08998100
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License Number State | NJ
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