Healthcare Provider Details

I. General information

NPI: 1952902421
Provider Name (Legal Business Name): DAOYU YANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2020
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 HAMILTON AVE
TRENTON NJ
08629-1915
US

IV. Provider business mailing address

1808 NOTTINGHILL LN
HAMILTON NJ
08619-4026
US

V. Phone/Fax

Practice location:
  • Phone: 609-599-5000
  • Fax:
Mailing address:
  • Phone: 609-647-3223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0448404
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: