Provider Demographics
NPI:1205272127
Name:TUNG, LILY (MD)
Entity type:Individual
Prefix:DR
First Name:LILY
Middle Name:
Last Name:TUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 N. 39TH STREET, SUITE 120
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-662-7320
Mailing Address - Fax:215-243-4605
Practice Address - Street 1:51 N. 39TH STREET, SUITE 120
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-662-7320
Practice Address - Fax:215-243-4605
Is Sole Proprietor?:No
Enumeration Date:2013-05-18
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4609002086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care