Provider Demographics
NPI:1053590521
Name:LI CHIRO AND REHAB PLLC
Entity type:Organization
Organization Name:LI CHIRO AND REHAB PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:V
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:516-752-1910
Mailing Address - Street 1:56A MOTOR AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-4038
Mailing Address - Country:US
Mailing Address - Phone:516-752-1910
Mailing Address - Fax:516-752-1914
Practice Address - Street 1:2751 27TH ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-2451
Practice Address - Country:US
Practice Address - Phone:718-728-0612
Practice Address - Fax:718-545-7771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00X2629111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY08356Medicare PIN
NY08356HMedicare PIN