Healthcare Provider Details

I. General information

NPI: 1033653332
Provider Name (Legal Business Name): TINA YEUNG M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2016
Last Update Date: 12/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13720 FRANKLIN AVE PS244 - TALES ROOM 304
FLUSHING NY
11355-3871
US

IV. Provider business mailing address

232 E 116TH ST APT 17
NEW YORK NY
10029-1433
US

V. Phone/Fax

Practice location:
  • Phone: 718-445-5730
  • Fax:
Mailing address:
  • Phone: 330-984-9066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number026330
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: