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Jianjun Li Gi Medical Pc

Specialist

Other Service Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Jianjun Li Gi Medical Pc does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1538340203
Provider Type
Organization
Full Name
Jianjun Li Gi Medical Pc

Subpart
No
Enumeration Date
11/21/2007
Last Updated
3/31/2015

Contact Information

Practice Location

730 58th St, Brooklyn, NY 11220-3917

(718) 567-8808

(718) 567-8820

Mailing Location

730 58th St, Brooklyn, NY 11220-3917

(718) 567-8808

(718) 567-8820

Authorized Official

Chan, Winnie (Office Manager)

(718) 567-8808

Provider Taxonomies

Code	Description	License
Code 174400000X Primary	Description Specialist Other Service Providers	License 203883 New York
Code 174400000X	Description Specialist Other Service Providers	License 244434 New York
Code 174400000X	Description Specialist Other Service Providers	License 257725 New York
Code 174400000X	Description Specialist Other Service Providers	License 25MA08744000 New Jersey
Code 174400000X	Description Specialist Other Service Providers	License 25MA09606000 New Jersey
Code 174400000X	Description Specialist Other Service Providers	License 25MA09610400 New Jersey

Provider Identifiers

ID	Description	Issuer
ID 02577640	Description Medicaid	Issuer Unlisted New York

Jianjun Li Gi Medical Pc

PECOS Enrollment

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