Individual provider · Type 1 NPI

Kevin Ly

Family Medicine Physician · Bloomsburg, PA

NPI number 1720564289 Active

Practice location

240 Mall Blvd
Bloomsburg, PA 17815-8306

Call (570) 784-8303 Map

Fax (570) 387-5030

Mailing address

100 N Academy Ave
Danville, PA 17822-4903

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	MD475200 (PA)

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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About NPI 1720564289

Kevin Ly's National Provider Identifier is 1720564289, issued on Jul 17, 2018. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Bloomsburg, PA. The record was last updated on Sep 11, 2025.