Provider Demographics
NPI:1114800620
Name:LI NP IN FAMILY HEALTH AND ADULT HEALTH PLLC
Entity type:Organization
Organization Name:LI NP IN FAMILY HEALTH AND ADULT HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MICAELA
Authorized Official - Middle Name:
Authorized Official - Last Name:VIRGILIO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:516-250-3044
Mailing Address - Street 1:28 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11782-3104
Mailing Address - Country:US
Mailing Address - Phone:516-250-3044
Mailing Address - Fax:631-938-9451
Practice Address - Street 1:28 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11782-3104
Practice Address - Country:US
Practice Address - Phone:516-250-3044
Practice Address - Fax:631-938-9451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty