NPI 1770560542 · live from the CMS NPI Registry
Justin Q. Ly, M.D.
Radiology, Diagnostic Radiology in Eden Prairie, MN. National Provider Identifier 1770560542, active.
NPI record
| NPI | 1770560542 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Radiology, Diagnostic Radiology 2085R0202X |
| Practice location | 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344 |
| Practice phone | 952-595-1301 |
| Enumerated | December 22, 2005 |
| Last updated | June 20, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Radiology, Diagnostic Radiology | 2085R0202X | 244268 (NY) |
| Radiology, Diagnostic Radiology | 2085R0202X | MD210002606 (DC) |
| Radiology, Diagnostic Radiology primary | 2085R0202X | A90777 (CA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.