Provider Demographics
NPI:1871761866
Name:EMPIRE MEDICINE & REHABILITATION
Entity type:Organization
Organization Name:EMPIRE MEDICINE & REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YALI
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-360-7380
Mailing Address - Street 1:45 TERRY RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-3894
Mailing Address - Country:US
Mailing Address - Phone:631-360-7380
Mailing Address - Fax:631-360-3095
Practice Address - Street 1:45 TERRY RD
Practice Address - Street 2:SUITE B
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3894
Practice Address - Country:US
Practice Address - Phone:631-360-7380
Practice Address - Fax:631-360-3095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228399208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty