Healthcare Provider Details

I. General information

NPI: 1538391461
Provider Name (Legal Business Name): YAN CHUN MUI RN, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2009
Last Update Date: 05/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 WALKER ST
NEW YORK NY
10013
US

IV. Provider business mailing address

2121 E 16TH ST
BROOKLYN NY
11229-4401
US

V. Phone/Fax

Practice location:
  • Phone: 212-226-8866
  • Fax: 121-226-2289
Mailing address:
  • Phone: 718-645-1058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number492568
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number492568
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: