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General NPI Number Information
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NPI Number | 1073960480
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Entity Type | Individual
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Provider Name | SERENA YANG LY PHARMD, BCPS
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Gender | Female
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Dates
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Enumeration Date | 05/16/2016
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Last Update Date | 05/16/2016
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Provider Practice Location Address
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Address Line | 201 E UNIVERSITY PKWY
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City | BALTIMORE
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State | MD
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Zip | 21218-2829
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Country | US
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Telephone | 410-554-2555
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Fax |
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Provider Business Mailing Address
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Address Line | 12604 W OLD BALTIMORE RD
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City | BOYDS
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State | MD
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Zip | 20841-9008
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Country | US
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Telephone | 757-470-8676
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 20743
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License Number State | MD
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