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General NPI Number Information
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NPI Number | 1750791406
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Entity Type | Individual
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Provider Name | CATHERINE LYNN LY MD
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Gender | Female
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Dates
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Enumeration Date | 05/03/2014
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Last Update Date | 03/14/2023
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Provider Practice Location Address
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Address Line | 1275 YORK AVE
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City | NEW YORK
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State | NY
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Zip | 10065-6007
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Country | US
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Telephone | 646-608-8639
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Fax |
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Provider Business Mailing Address
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Address Line | 1275 YORK AVE
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City | NEW YORK
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State | NY
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Zip | 10065-6007
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Country | US
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Telephone |
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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 | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 283859
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License Number State | NY
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