Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kenneth Ly

Individual provider Family Medicine Physician · NPI 1104558170

Kenneth Ly is a Family Practice in Phillipsburg, New Jersey. Qualified in 2021, 5 years ago. Practices with St Lukes Warren Physician Group PC, a 378-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New Jersey.

Years since qualifying
5
Licensed in
NJ
In the registry since
2022
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Practice location Address checks out

200 Strykers Rd Ste 1
Phillipsburg, NJ 08865-9465
Phone: (908) 847-6568
Fax: (866) 278-3009
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 25MA12797600 (NJ)

Record details

NPI number1104558170
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 28, 2022
Last updated in NPPESAugust 25, 2025
Certification dateAugust 12, 2025
Mailing address200 Strykers Rd Ste 1, Phillipsburg, NJ 08865-9465

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice St Lukes Warren Physician Group Pc — 378 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Phillipsburg