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General NPI Number Information
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NPI Number | 1194871475
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Entity Type | Organization
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Legal Business Name | DR YU'S FAMILY PRACTICE PLLC
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 07/01/2008
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Provider Practice Location Address
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Address Line | 8704A ROCKAWAY BEACH BLVD
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City | ROCKAWAY BEACH
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State | NY
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Zip | 11693-1610
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Country | US
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Telephone | 718-945-6500
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Fax | 718-945-6509
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Provider Business Mailing Address
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Address Line | 8704A ROCKAWAY BEACH BLVD
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City | ROCKAWAY BEACH
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State | NY
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Zip | 11693-1610
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Country | US
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Telephone | 718-945-6500
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Fax | 718-945-6509
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Authorized Official
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Title or Position | SOLE OWNER
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Name | DR. KYI WIN YU
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Credential | MD
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Telephone | 718-945-6500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 204315
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License Number State | NY
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