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General NPI Number Information
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NPI Number | 1194135483
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Entity Type | Organization
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Legal Business Name | DIABETES AND ENDOCRINE CARE OF LONG ISLAND PLLC
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Dates
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Enumeration Date | 05/07/2014
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Last Update Date | 08/06/2014
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Provider Practice Location Address
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Address Line | 175 JERICHO TPKE SUITE 300
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City | SYOSSET
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State | NY
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Zip | 11791-4532
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Country | US
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Telephone | 516-496-1616
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Fax | 516-496-1617
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Provider Business Mailing Address
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Address Line | 92 PARK LANE DR
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City | ALBERTSON
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State | NY
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Zip | 11507-1320
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Country | US
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Telephone | 646-734-2978
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. NAMYI YU
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Credential | MD
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Telephone | 646-734-2978
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 222570
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License Number State | NY
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