Healthcare Provider Details

I. General information

NPI: 1740553700
Provider Name (Legal Business Name): AN LAP LY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MR. ANDY LAP LY

II. Dates (important events)

Enumeration Date: 02/21/2012
Last Update Date: 02/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33162 DEQUINDRE RD
STERLING HEIGHTS MI
48310-5915
US

IV. Provider business mailing address

33162 DEQUINDRE RD
STERLING HEIGHTS MI
48310-5915
US

V. Phone/Fax

Practice location:
  • Phone: 586-977-0202
  • Fax: 586-977-6688
Mailing address:
  • Phone: 586-977-0202
  • Fax: 586-977-6688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD5476V
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License NumberD5476V
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License NumberD5476V
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: