MEDICARE: DR. AUDREY JANE YUE OD

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	152W00000X	Optometrist	009610	NY

General Provider Information

NPI Number	:	1750016275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUDREY JANE YUE OD

Provider Business Mailing Address
First Line	:	229 W 60TH ST APT 4J
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-7506
Country	:	US
Telephone Number	:	917-880-7936
Fax Number	:

Provider Business Practice Location Address
First Line	:	213 W 79TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-6241
Country	:	US
Telephone Number	:	212-724-8855
Fax Number	:

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

Provider Enumeration Date	:	07/19/2022
Last Update Date	:	07/19/2022

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