MEDICARE: ERIC YUAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	2084P0800X	Psychiatry Physician	C1-0029695	DE
3	2084P0800X	Psychiatry Physician	342761	NY

General Provider Information

NPI Number	:	1225772247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC YUAN

Provider Business Mailing Address
First Line	:	1901 1ST AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-7491
Country	:	US
Telephone Number	:	844-692-4692
Fax Number	:

Provider Business Practice Location Address
First Line	:	1901 1ST AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-7491
Country	:	US
Telephone Number	:	844-692-4692
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2022
Last Update Date	:	06/12/2026

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Directions to “ ERIC YUAN ” Practice Location

Language	Start Address	Practice Location

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