Mamaroneck Medical, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

218148 Issued in NY

Legal business name

MAMARONECK MEDICAL, PLLC

Practice address

933 Mamaroneck Ave
Suite 102
Mamaroneck, NY 10543-1662

Phone

(914) 523-1948

NPI assigned

Nov 18, 2014

Last updated

Jul 6, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lili Kung, M.D.NPI 1104888221

Title

Physician

Phone

(914) 523-1948

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lili Kung, MD

  • Family Medicine Physician
  • Mamaroneck, NY
  • NPI 1104888221
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436140800000",
    "number": "1992101984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 204",
            "city": "MAMARONECK",
            "state": "NY",
            "postal_code": "105430204",
            "telephone_number": "914-523-1948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 MAMARONECK AVE",
            "address_2": "SUITE 102",
            "city": "MAMARONECK",
            "state": "NY",
            "postal_code": "105431662",
            "telephone_number": "914-523-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAMARONECK MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-18",
        "last_updated": "2015-07-06",
        "status": "A",
        "authorized_official_last_name": "KUNG",
        "authorized_official_first_name": "LILI",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "914-523-1948",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "218148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Damon O'Brian Malcolm
• Kevin J Maloney, MD
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• Mamaroneck Foot Care
• Mamaroneck NP in Psychiatry PLLC
• Mamaroneck Public Schools
• Mamaroneck Union Free School District
• Mamaroneck Vision Center, Inc. (Raymond Opticians)
• Gladys Manosalvas

• Family Medicine Physician in Mamaroneck, NY
• Providers in Mamaroneck, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.