Individual ProviderKenneth LyFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address200 Strykers Rd Ste 1, Phillipsburg, NJ 08865-9465(908) 847-6568PECOS EnrollmentBased on the most recent information from CMS, provider Kenneth Ly is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1104558170Provider TypeIndividualFull NameLy, KennethGenderMaleSole ProprietorNoEnumeration Date6/28/2022Last Updated8/25/2025Contact InformationPractice LocationPractice Address200 Strykers Rd Ste 1, Phillipsburg, NJ 08865-9465Phone(908) 847-6568Fax(866) 278-3009Mailing LocationMailing Address200 Strykers Rd Ste 1, Phillipsburg, NJ 08865-9465Phone(908) 847-6568Fax(866) 278-3009Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense25MA12797600New Jersey