Healthcare Provider Details

I. General information

NPI: 1275928285
Provider Name (Legal Business Name): YAWEI YANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2015
Last Update Date: 11/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 YORK AVE
NEW YORK NY
10065-4805
US

IV. Provider business mailing address

1300 YORK AVE
NEW YORK NY
10065-4805
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-3971
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0007X
TaxonomyMolecular Genetic Pathology (Pathology) Physician
License Number292221
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License Number292221
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: