Provider Demographics
NPI:1801554555
Name:NGO, LILY AN (PA-C)
Entity type:Individual
Prefix:
First Name:LILY
Middle Name:AN
Last Name:NGO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:145 BENT TREE DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-9437
Mailing Address - Country:US
Mailing Address - Phone:717-406-8522
Mailing Address - Fax:
Practice Address - Street 1:864 COUNTY LINE RD STE 17
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-2516
Practice Address - Country:US
Practice Address - Phone:484-222-6222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA063276363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant