Provider Demographics
NPI:1851646301
Name:LIMIN MEDICAL NY P.C
Entity Type:Organization
Organization Name:LIMIN MEDICAL NY P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YONG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-577-6657
Mailing Address - Street 1:45 HILL PARK AVE APT 1S
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-3722
Mailing Address - Country:US
Mailing Address - Phone:646-577-6657
Mailing Address - Fax:516-708-9634
Practice Address - Street 1:299 E SHORE RD STE 204
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-2429
Practice Address - Country:US
Practice Address - Phone:917-868-2828
Practice Address - Fax:516-466-4015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-20
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243073208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02971777Medicaid