Healthcare Provider Details

I. General information

NPI: 1568098424
Provider Name (Legal Business Name): YANGCHEN LHAMU FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2020
Last Update Date: 04/19/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2127 71ST ST
EAST ELMHURST NY
11370-1004
US

IV. Provider business mailing address

2127 71ST ST
EAST ELMHURST NY
11370-1004
US

V. Phone/Fax

Practice location:
  • Phone: 646-812-0046
  • Fax:
Mailing address:
  • Phone: 646-812-0046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF343545-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: