Individual
ANDY LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8200 ROOSEVELT BLVD, PHILADELPHIA, PA 19152-2519
(215) 338-4967
(215) 338-2437
Mailing address
4010 K ST, PHILADELPHIA, PA 19124-5219
(267) 250-1086
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP45701
PA
Other
Enumeration date
06/27/2021
Last updated
08/16/2022
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