Healthcare Provider Details

I. General information

NPI: 1831602945
Provider Name (Legal Business Name): CAMERON JAMES YUEN PT, DPT, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2017
Last Update Date: 11/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 MADISON AVE RM 1826
NEW YORK NY
10017-6337
US

IV. Provider business mailing address

78 MANHATTAN AVE APT 3F
NEW YORK NY
10025-4665
US

V. Phone/Fax

Practice location:
  • Phone: 646-596-7427
  • Fax:
Mailing address:
  • Phone: 858-736-4704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number042551
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: