Healthcare Provider Details

I. General information

NPI: 1376479493
Provider Name (Legal Business Name): MASSAGE OF YANG DU PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 DUFF PL STE E
SEAFORD NY
11783-1324
US

IV. Provider business mailing address

3242 91ST ST APT 303
EAST ELMHURST NY
11369-2333
US

V. Phone/Fax

Practice location:
  • Phone: 917-935-8410
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: YANG DU
Title or Position: PRESIDENT
Credential:
Phone: 917-499-8795