MEDICARE: BOEY LI MD

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
1	207P00000X	Emergency Medicine Physician	328909	NY

General Provider Information

NPI Number	:	1255968152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BOEY LI MD

Provider Business Mailing Address
First Line	:	62 LARRISON LOOP
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-5086
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 PELHAM PKWY S BLDG 6
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1119
Country	:	US
Telephone Number	:	718-918-5820
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2020
Last Update Date	:	01/14/2026

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