MEDICARE: MICHAEL LI MD PLLC

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	174400000X	Specialist	2148511	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508891508
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL LI MD PLLC

Provider Business Mailing Address
First Line	:	136-20 38 AVE
Second Line	:	SUITE 6F
City	:	FLUSHING
State	:	NY
Zip	:	11354-4263
Country	:	US
Telephone Number	:	718-888-9700
Fax Number	:	718-888-9796

Provider Business Practice Location Address
First Line	:	13620 38TH AVE
Second Line	:	SUITE 6F
City	:	FLUSHING
State	:	NY
Zip	:	11354-4233
Country	:	US
Telephone Number	:	718-888-9700
Fax Number	:	718-888-9796

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. MICHAEL LI
Credential	:	MD PHD
Telephone Number	:	718-888-9700

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	07/01/2008

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