Individual ProviderAngela LyStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address507 N 17th St, Milwaukee, WI 53233-2104(414) 288-5688PECOS EnrollmentBased on the most recent information from CMS, provider Angela Ly does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1619800737Provider TypeIndividualFull NameLy, AngelaGenderFemaleSole ProprietorYesEnumeration Date6/8/2026Last Updated6/8/2026Contact InformationPractice LocationPractice Address507 N 17th St, Milwaukee, WI 53233-2104Phone(414) 288-5688FaxUnlisted FaxMailing LocationMailing Address507 N 17th St, Milwaukee, WI 53233-2104PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer