Provider Demographics
NPI:1457089559
Name:LE, VY (DPT)
Entity Type:Individual
Prefix:
First Name:VY
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-3895
Mailing Address - Country:US
Mailing Address - Phone:781-771-3010
Mailing Address - Fax:
Practice Address - Street 1:4110 MYSTIC VALLEY PKWY STE 12
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-6931
Practice Address - Country:US
Practice Address - Phone:781-960-6030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist