# LI MEDICAL OF NY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457605669
- **Authorized official:** SIMON LIPETZ MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (718) 275-5551

## Contact information

- **Practice address:** 7020 YELLOWSTONE BLVD, FOREST HILLS, NY 11375-3500
- **Practice address phone:** (718) 275-5551
- **Mailing address:** 7020 YELLOWSTONE BLVD, FOREST HILLS, NY 11375-3500
- **Mailing address phone:** (718) 275-5551

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | 186190 | NY | Yes |

## Other

- **Enumeration date:** 11/09/2012
- **Last updated:** 11/09/2012