Eddie Li OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

007896 Issued in NY

Legal business name

EDDIE LI OD PC

Practice address

7525 153Rd St
#147
Flushing, NY 11367-3090

Phone

(848) 565-8904

NPI assigned

Oct 16, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eddie Li, OD

Title

Owner

Phone

(848) 565-8904

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350345600000",
    "number": "1346593324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7525 153RD ST",
            "address_2": "#147",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7525 153RD ST",
            "address_2": "#147",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673090",
            "telephone_number": "848-565-8904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDDIE LI OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-16",
        "last_updated": "2012-10-16",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "848-565-8904",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "007896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.