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NPI Code Detail

MEDICARE: LYLY LEI FNP

MEDICARE:   LYLY  LEI  FNP
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
1363LF0000XFamily Nurse Practitioner356309NY

General Provider Information

NPI Number : 1023968526
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYLY LEI FNP
Provider Business Mailing Address
First Line : 87 WINFIELD ST
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10305-3545
Country : US
Telephone Number : 646-662-2894
Fax Number :
Provider Business Practice Location Address
First Line : 762 59TH ST STE 7
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-3920
Country : US
Telephone Number : 917-338-6688
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2026
Last Update Date : 02/02/2026

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