Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Evergreen Vitality Primary Care, P. C.

Organization Internal Medicine Physician · NPI 1053244384

Evergreen Vitality Primary Care, P. C. is an Internal Medicine Physician in Hartsdale, New York. Registered with an NPI since 2026.

In the registry since
2026
Specialties on file
2

Practice location Address checks out

280 N Central Ave Ste 312
Hartsdale, NY 10530-1839
Phone: (914) 439-2690
Fax: (351) 200-1199
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X
Internal Medicine Physician Taxonomy 207R00000X

Record details

NPI number1053244384
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Changqing Li — President · (347) 387-3954
NPI enumeratedJune 5, 2026
Last updated in NPPESAugust 6, 2026
Certification dateAugust 6, 2026
Mailing address280 N Central Ave Ste 312, Hartsdale, NY 10530-1839

Other providers in Hartsdale