Provider Demographics
NPI:1184763948
Name:CLAIRE M. LI, DC PC
Entity type:Organization
Organization Name:CLAIRE M. LI, DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:516-671-6763
Mailing Address - Street 1:66 LANDING RD
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-1844
Mailing Address - Country:US
Mailing Address - Phone:516-671-6763
Mailing Address - Fax:
Practice Address - Street 1:66 LANDING RD
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-1844
Practice Address - Country:US
Practice Address - Phone:516-671-6763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0042861111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY232063OtherWORKERS COMP BOARD #
NY=========OtherEIN
NYT52899Medicare UPIN
NY232063OtherWORKERS COMP BOARD #