MEDICARE: SEUNG-YUN YANG

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	235Z00000X	Speech-Language Pathologist	021374-1	NY

General Provider Information

NPI Number	:	1396036448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEUNG-YUN YANG

Provider Business Mailing Address
First Line	:	101 W 24TH ST
Second Line	:	APT 7B
City	:	NEW YORK
State	:	NY
Zip	:	10011-1909
Country	:	US
Telephone Number	:	562-760-6538
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 W 24TH ST
Second Line	:	APT 7B
City	:	NEW YORK
State	:	NY
Zip	:	10011-1909
Country	:	US
Telephone Number	:	562-760-6538
Fax Number	:

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

Provider Enumeration Date	:	04/25/2011
Last Update Date	:	12/13/2012

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Directions to “ SEUNG-YUN YANG ” Practice Location

Language	Start Address	Practice Location

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