Healthcare Provider Details

I. General information

NPI: 1518403021
Provider Name (Legal Business Name): LU-YING YANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LU YING YANG MD. SA

II. Dates (important events)

Enumeration Date: 01/09/2017
Last Update Date: 01/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BARNES JEWISH HOSPITAL PLZ
SAINT LOUIS MO
63110-1003
US

IV. Provider business mailing address

433 CLARA AVE, #8
ST. LOUIS MO
63112
US

V. Phone/Fax

Practice location:
  • Phone: 314-536-7799
  • Fax:
Mailing address:
  • Phone: 314-307-1641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number2000164933
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: