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General NPI Number Information
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NPI Number | 1225280589
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Entity Type | Individual
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Provider Name | LAWRENCE YANG M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/17/2008
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Last Update Date | 10/17/2008
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Provider Practice Location Address
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Address Line | 412 S BROADWAY
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City | HICKSVILLE
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State | NY
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Zip | 11801-5009
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Country | US
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Telephone | 516-938-1552
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Fax | 718-228-4726
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Provider Business Mailing Address
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Address Line | 28 SALEM RD
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City | HICKSVILLE
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State | NY
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Zip | 11801-5745
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Country | US
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Telephone | 718-986-9640
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Fax | 718-228-4726
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 250721
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License Number State | NY
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