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General NPI Number Information
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NPI Number | 1114794021
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Entity Type | Organization
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Legal Business Name | DR. LYB, LLC
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Dates
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Enumeration Date | 12/11/2023
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Last Update Date | 12/11/2023
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Provider Practice Location Address
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Address Line | 4870 SADLER RD STE 300
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City | GLEN ALLEN
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State | VA
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Zip | 23060-6294
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Country | US
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Telephone | 804-299-3989
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Fax |
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Provider Business Mailing Address
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Address Line | 4870 SADLER RD STE 300
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City | GLEN ALLEN
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State | VA
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Zip | 23060-6294
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Country | US
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Telephone | 804-299-3989
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | ALLA LERNER-BRANDON
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Credential | MD
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Telephone | 804-299-3989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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