Healthcare Provider Details

I. General information

NPI: 1447282595
Provider Name (Legal Business Name): WING KI YEUNG PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY YEUNG PT

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 04/14/2021
Certification Date: 04/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5589 TRANSIT RD
EAST AMHERST NY
14051-1805
US

IV. Provider business mailing address

BOX 8000 DEPT 314
BUFFALO NY
14267-0002
US

V. Phone/Fax

Practice location:
  • Phone: 716-568-1251
  • Fax: 716-568-1253
Mailing address:
  • Phone: 716-213-0772
  • Fax: 716-324-5004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number020638
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: