Active NPI
Mack Li
- Pharmacist
- Lawrence, NY
National Provider Identifier
1316604317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 068324
- Practice address
- 298 Central Ave
Lawrence, NY 11559-1606 - Phone
- (516) 418-3539
- NPI assigned
- Nov 24, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 068324 | NY | Primary |
Addresses
Primary practice location
298 Central Ave
Lawrence, NY 11559-1606
Mailing address
298 Central Ave
Lawrence, NY 11559-1606
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RE91222D | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 068324 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651190400000",
"number": "1316604317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "298 CENTRAL AVE",
"city": "LAWRENCE",
"state": "NY",
"postal_code": "115591606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "298 CENTRAL AVE",
"city": "LAWRENCE",
"state": "NY",
"postal_code": "115591606",
"telephone_number": "516-418-3539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LI",
"first_name": "MACK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-24",
"last_updated": "2022-04-29",
"certification_date": "2022-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "068324",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "RE91222D",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.