MEDICARE: LY MEDICAL DIAGNOSTICS PLLC

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
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1164227559
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LY MEDICAL DIAGNOSTICS PLLC

Provider Business Mailing Address
First Line	:	6910 174TH ST
Second Line	:
City	:	FRESH MEADOWS
State	:	NY
Zip	:	11365-3411
Country	:	US
Telephone Number	:	718-888-1117
Fax Number	:

Provider Business Practice Location Address
First Line	:	533 48TH AVE
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-5605
Country	:	US
Telephone Number	:	718-888-1117
Fax Number	:

Authorized Official
Title or Position	:	EMPLOYEE
Name	:	LOK YUNG
Credential	:	MD
Telephone Number	:	718-888-1117

Provider Enumeration Date	:	02/18/2025
Last Update Date	:	02/20/2025

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Directions to “LY MEDICAL DIAGNOSTICS PLLC ” Practice Location

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