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General NPI Number Information
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NPI Number | 1265061691
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Entity Type | Individual
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Provider Name | KEVIN YIMING YAN MD
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Gender | Male
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Dates
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Enumeration Date | 04/07/2020
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 17 E 102ND ST FL 8
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City | NEW YORK
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State | NY
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Zip | 10029-5204
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Country | US
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Telephone | 212-241-1159
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Fax | 332-777-0566
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Provider Business Mailing Address
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Address Line | 1365B CLIFTON RD NE STE B4500
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City | ATLANTA
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State | GA
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Zip | 30322-1013
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Country | US
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Telephone | 404-778-5360
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Fax | 404-778-4849
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 333715
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207WX0109X
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Taxonomy Name | Neuro-ophthalmology Physician
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License Number | 333715
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License Number State | NY
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