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General NPI Number Information
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NPI Number | 1235648650
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Entity Type | Organization
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Legal Business Name | YANG TMS CENTER OF THE MAIN LINE
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Dates
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Enumeration Date | 09/28/2017
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Last Update Date | 11/15/2019
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Provider Practice Location Address
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Address Line | 940 E HAVERFORD RD STE 201B
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City | BRYN MAWR
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State | PA
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Zip | 19010-3845
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Country | US
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Telephone | 610-520-1128
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Fax |
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Provider Business Mailing Address
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Address Line | 940 E HAVERFORD RD STE 201B
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City | BRYN MAWR
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State | PA
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Zip | 19010-3845
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Country | US
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Telephone | 610-520-1128
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Fax |
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Authorized Official
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Title or Position | SOLE OWNER
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Name | JINGDUAN YANG
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Credential | MD
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Telephone | 610-520-1128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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