MEDICARE: DR. TUNG PHI LY PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	060049	NY

General Provider Information

NPI Number	:	1023415742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TUNG PHI LY PHARM.D.

Provider Business Mailing Address
First Line	:	1085 ASTOR AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10469-4809
Country	:	US
Telephone Number	:	917-574-6256
Fax Number	:

Provider Business Practice Location Address
First Line	:	1085 ASTOR AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10469-4809
Country	:	US
Telephone Number	:	917-574-6256
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2014
Last Update Date	:	06/28/2016

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