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1259 Rt 46 East, Troy Office Center Suite 101, Building 4c Parsippany NJ 07054 | |
(873) 257-8870 | |
(973) 257-8871 |
Full Name | |
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Speciality | Family Medicine |
Location | 1259 Rt 46 East, Troy Office Center, Parsippany, New Jersey |
Authorized Official Name and Position | Annie Hongyan Li (OWNER/PRESIDENT) |
Authorized Official Contact | 9732578870 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1259 Rt 46 East, Troy Office Center Suite 101, Building 4c Parsippany NJ 07054 Ph: (873) 257-8870 | 1259 Rt 46 East, Troy Office Center Suite 101, Building 4c Parsippany NJ 07054 Ph: (873) 257-8870 |
NPI Number | 1063748747 |
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Provider Enumeration Date | 10/30/2009 |
Last Update Date | 10/30/2009 |
Medicare PECOS PAC ID | 7810127362 |
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Medicare Enrollment ID | O20140228000467 |
Identifier | Type | State | Issuer |
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1063748747 | NPI | - | NPPES |
8582301 | Medicaid | NJ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | MA071077 (New Jersey) | Primary |
Provider Name | Annie Hongyan Li |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1548298581 PECOS PAC ID: 0143210435 Enrollment ID: I20040518000144 |
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