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NPI Code Detail

MEDICARE: CONRAD LI M.D.

MEDICARE: CONRAD LI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician280627NY

General Provider Information

NPI Number : 1013271741
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONRAD LI M.D.
Provider Business Mailing Address
First Line : 13620 MAPLE AVE # C702
Second Line :
City : FLUSHING
State : NY
Zip : 11355-5166
Country : US
Telephone Number : 347-368-4288
Fax Number : 347-368-4785
Provider Business Practice Location Address
First Line : 13620 MAPLE AVE # C702
Second Line :
City : FLUSHING
State : NY
Zip : 11355-5166
Country : US
Telephone Number : 347-368-4288
Fax Number : 347-368-4785
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2012
Last Update Date : 06/06/2025

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