Individual
JUSTIN ALEXANDER LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 N BROAD ST, DEPARTMENT OF ORTHOPADIC SURGERY & SPORTS MEDICINE, PHILADELPHIA, PA 19140
(484) 343-3159
Mailing address
3509 N BROAD ST, BOYER PAVILLION SUITE 226 SUITE 226P, PHILADELPHIA, PA 19140
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MT225615
PA
Other
Enumeration date
06/07/2022
Last updated
06/07/2022
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