| Li Medical Group Pllc | |
|
2090 Jericho Tpke New Hyde Park NY 11040-4719 | |
| (516) 352-7828 | |
| Not Available |
| Full Name | Li Medical Group Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2090 Jericho Tpke, New Hyde Park, New York |
| Authorized Official Name and Position | Luke Walton (ENROLLMENT MANAGER) |
| Authorized Official Contact | 9519003156 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Li Medical Group Pllc 2090 Jericho Tpke New Hyde Park NY 11040-4719 Ph: () - | Li Medical Group Pllc 2090 Jericho Tpke New Hyde Park NY 11040-4719 Ph: (516) 352-7828 |
| NPI Number | 1144878414 |
|---|---|
| Provider Enumeration Date | 08/29/2019 |
| Last Update Date | 06/10/2020 |
| Medicare PECOS PAC ID | 7517397045 |
|---|---|
| Medicare Enrollment ID | O20221215002053 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144878414 | NPI | - | NPPES |
| 01439550 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Zinovy Kozlov |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679505002 PECOS PAC ID: 4284620105 Enrollment ID: I20040423001360 |
| Provider Name | Valsa John |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700955481 PECOS PAC ID: 5092705608 Enrollment ID: I20040515000245 |
| Provider Name | Vibhu Narang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1356471643 PECOS PAC ID: 3173560687 Enrollment ID: I20050601000218 |
| Provider Name | Steven M Winograd |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1811972870 PECOS PAC ID: 8022903210 Enrollment ID: I20070202000535 |
| Provider Name | Michael Donald Tang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780874461 PECOS PAC ID: 3678662475 Enrollment ID: I20071201000098 |
| Provider Name | Jonathan Aronbayev |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750318721 PECOS PAC ID: 2567649650 Enrollment ID: I20110526000352 |
| Provider Name | Boris Byalik |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1346450897 PECOS PAC ID: 7618155433 Enrollment ID: I20110627000649 |
| Provider Name | Magdalena Marta Morkis-madaj |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700140928 PECOS PAC ID: 8123337375 Enrollment ID: I20161020000815 |
| Provider Name | Indravadan Dave |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1497799944 PECOS PAC ID: 6709846363 Enrollment ID: I20190326002935 |
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