Individual
DR. JOHNATHAN LY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5645 MAIN ST, EMERGENCY DEPARTMENT, FLUSHING, NY 11355
(718) 670-1100
Mailing address
50 SARATOGA AVE, SANTA CLARA, CA 95051-7387
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
292237
NY
Other
Enumeration date
05/18/2015
Last updated
08/29/2019
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