Provider Demographics
NPI:1952368177
Name:LY, VANTHANH (MD)
Entity Type:Individual
Prefix:DR
First Name:VANTHANH
Middle Name:
Last Name:LY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:800 POLY PL RM 13-105
Mailing Address - Street 2:PULMONARY SECTION
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-7104
Mailing Address - Country:US
Mailing Address - Phone:718-630-3722
Mailing Address - Fax:718-630-2889
Practice Address - Street 1:800 POLY PL RM 13-105
Practice Address - Street 2:PULMONARY SECTION
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7104
Practice Address - Country:US
Practice Address - Phone:718-630-3722
Practice Address - Fax:718-630-2889
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2007-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY215059207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine