Healthcare Provider Details

I. General information

NPI: 1972248045
Provider Name (Legal Business Name): SAPANA YONGHANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2022
Last Update Date: 10/15/2023
Certification Date: 03/20/2023
Deactivation Date: 03/20/2023
Reactivation Date: 10/13/2023

III. Provider practice location address

760 BROADWAY
BROOKLYN NY
11206
US

IV. Provider business mailing address

760 BROADWAY DEPARTMENT OF MEDICINE, 8TH FLOOR
BROOKLYN NY
11206
US

V. Phone/Fax

Practice location:
  • Phone: 718-963-5821
  • Fax:
Mailing address:
  • Phone: 718-963-5807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: