MEDICARE: LI-MIN YANG M.D.

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	208000000X	Pediatrics Physician	240002	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447286323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LI-MIN YANG M.D.

Provider Business Mailing Address
First Line	:	22116 UNION TPKE
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11364-3641
Country	:	US
Telephone Number	:	718-465-5888
Fax Number	:	718-465-5889

Provider Business Practice Location Address
First Line	:	22116 UNION TPKE
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11364-3641
Country	:	US
Telephone Number	:	718-465-5888
Fax Number	:	718-465-5889

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	03/06/2012

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