Healthcare Provider Details

I. General information

NPI: 1720352081
Provider Name (Legal Business Name): HOMAN YEUNG D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2012
Last Update Date: 11/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 W SUFFOLK AVE
CENTRAL ISLIP NY
11722-2144
US

IV. Provider business mailing address

7312 172ND ST
FRESH MEADOWS NY
11366-1421
US

V. Phone/Fax

Practice location:
  • Phone: 347-681-2110
  • Fax:
Mailing address:
  • Phone: 347-681-2110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number004945
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX012058-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: