Provider Demographics
NPI:1508853201
Name:LI, KARL I-MING (MD)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:I-MING
Last Name:LI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:19 BRADHURST AVE
Mailing Address - Street 2:STE 1400
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-2140
Mailing Address - Country:US
Mailing Address - Phone:914-493-8333
Mailing Address - Fax:914-594-4366
Practice Address - Street 1:19 BRADHURST AVE
Practice Address - Street 2:STE. 1400
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2140
Practice Address - Country:US
Practice Address - Phone:914-493-8333
Practice Address - Fax:914-594-4366
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2010-11-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1672642080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00971279Medicaid
NY78D52EA202Medicare PIN
NYA64281Medicare UPIN
NY78D521Medicare PIN
NY78D52EA201Medicare PIN