Healthcare Provider Details

I. General information

NPI: 1538621834
Provider Name (Legal Business Name): YU MI KANG M.D., PH.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2019
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 LONGWOOD AVE FL 2
BOSTON MA
02115-5817
US

IV. Provider business mailing address

221 LONGWOOD AVE FL 2
BOSTON MA
02115-5817
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-5666
  • Fax:
Mailing address:
  • Phone: 617-732-5666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number292673
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number292673
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number292673
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code207QB0505X
TaxonomyDiabetology (Internal Medicine) Physician
License Number292673
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: