Healthcare Provider Details

I. General information

NPI: 1265794796
Provider Name (Legal Business Name): CATHERINE S. YANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2012
Last Update Date: 10/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 LONGWOOD AVE DEPARTMENT OF DERMATOLOGY
BOSTON MA
02115-5804
US

IV. Provider business mailing address

221 LONGWOOD AVE DEPARTMENT OF DERMATOLOGY
BOSTON MA
02115-5804
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-4918
  • Fax: 617-582-6060
Mailing address:
  • Phone: 617-732-4918
  • Fax: 617-582-6060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number265831
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: