Healthcare Provider Details

I. General information

NPI: 1912520396
Provider Name (Legal Business Name): PATRICK YEUNG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2020
Last Update Date: 05/20/2020
Certification Date: 05/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 SUMMER ST
NORTH BROOKFIELD MA
01535-1418
US

IV. Provider business mailing address

24 SUMMER ST
NORTH BROOKFIELD MA
01535-1418
US

V. Phone/Fax

Practice location:
  • Phone: 781-775-6928
  • Fax: 774-449-8074
Mailing address:
  • Phone: 781-775-6928
  • Fax: 774-449-8074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: