Organization
EVERGREEN VITALITY PRIMARY CARE, P. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHANGQING LI MD (PRESIDENT)
(347) 387-3954
Entity
Organization
Contact information
Practice address
280 N CENTRAL AVE STE 312, HARTSDALE, NY 10530-1839
(914) 439-2690
(351) 200-1199
Mailing address
280 N CENTRAL AVE STE 312, HARTSDALE, NY 10530-1839
(914) 439-2690
(351) 200-1199
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/05/2026
Last updated
08/06/2026
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