Daniel Chan Ly, DO | |
1431 Nursery St Ste 102, Fogelsville, PA 18051-1612 | |
(610) 821-4920 | |
(610) 821-1358 |
Full Name | Daniel Chan Ly |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 1431 Nursery St Ste 102, Fogelsville, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1194217224 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | OT018602 (Pennsylvania) | Secondary |
208000000X | Pediatrics | OS021279 (Pennsylvania) | Primary |
Entity Name | Lehigh Valley Physician Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457309650 PECOS PAC ID: 3072425123 Enrollment ID: O20040227000335 |
Mailing Address | Practice Location Address |
---|---|
Daniel Chan Ly, DO 2100 Mack Blvd, Allentown, PA 18103-5622 Ph: (484) 884-0617 | Daniel Chan Ly, DO 1431 Nursery St Ste 102, Fogelsville, PA 18051-1612 Ph: (610) 821-4920 |
Natalie K Caruso, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 1431 Nursery St Ste 102, Fogelsville, PA 18051 Phone: 610-336-8277 | |
Dr. Michael Lenneville, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1431 Nursery St Ste 102, Fogelsville, PA 18051 Phone: 610-821-4920 | |
Katelyn Suzanne Lindner, D.O. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1431 Nursery St, Fogelsville, PA 18051 Phone: 610-821-4920 Fax: 610-821-1358 |