| Li Complementary & Family Medical Care, P.c. | |
|
112 Alexander Ave Unit B Lake Grove NY 11755-0429 | |
| (631) 265-8258 | |
| (631) 265-8256 |
| Full Name | Li Complementary & Family Medical Care, P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 112 Alexander Ave Unit B, Lake Grove, New York |
| Authorized Official Name and Position | James Y.z. Wu (MEDICAL DIRECTOR) |
| Authorized Official Contact | 6312658258 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Li Complementary & Family Medical Care, P.c. 112 Alexander Ave Unit B Lake Grove NY 11755-0429 Ph: (631) 265-8258 | Li Complementary & Family Medical Care, P.c. 112 Alexander Ave Unit B Lake Grove NY 11755-0429 Ph: (631) 265-8258 |
| NPI Number | 1922177419 |
|---|---|
| Provider Enumeration Date | 11/07/2006 |
| Last Update Date | 09/23/2021 |
| Medicare PECOS PAC ID | 8426068511 |
|---|---|
| Medicare Enrollment ID | O20060503000818 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922177419 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 229361 (New York) | Primary |
| Provider Name | James Yong Zhen Wu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124117189 PECOS PAC ID: 4183607559 Enrollment ID: I20040608001187 |
Prevent Diagnostic Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Wood Rd, Lake Grove, NY 11755 Phone: 631-676-4336 Fax: 631-676-4337 | |
North Shore Regional Mri Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2780 Middle Country Road, Suite 305, Lake Grove, NY 11755 Phone: 631-689-5252 Fax: 631-689-5934 |