Healthcare Provider Details

I. General information

NPI: 1942113030
Provider Name (Legal Business Name): FNU TENZIN YANGCHEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 BROADHOLLOW RD STE 200
MELVILLE NY
11747-4833
US

IV. Provider business mailing address

3957 64TH ST # 1F
WOODSIDE NY
11377-3650
US

V. Phone/Fax

Practice location:
  • Phone: 888-722-2072
  • Fax: 802-288-0943
Mailing address:
  • Phone: 802-288-0943
  • Fax: 802-288-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberN46201
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: