Provider Demographics
NPI:1497569669
Name:LY, SETHARETH HY
Entity type:Individual
Prefix:
First Name:SETHARETH
Middle Name:HY
Last Name:LY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SETHARETH
Other - Middle Name:
Other - Last Name:HY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4199 HOLSTEIN DR
Mailing Address - Street 2:
Mailing Address - City:OBETZ
Mailing Address - State:OH
Mailing Address - Zip Code:43207-3773
Mailing Address - Country:US
Mailing Address - Phone:562-480-9475
Mailing Address - Fax:
Practice Address - Street 1:4199 HOLSTEIN DR
Practice Address - Street 2:
Practice Address - City:OBETZ
Practice Address - State:OH
Practice Address - Zip Code:43207-3773
Practice Address - Country:US
Practice Address - Phone:562-480-9475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health