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General NPI Number Information
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NPI Number | 1316365216
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Entity Type | Individual
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Provider Name | WENTAO YANG NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 03/29/2014
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1 CELLINI PL STE 102
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City | WEST HAVEN
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State | CT
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Zip | 06516-1666
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Country | US
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Telephone | 203-932-6481
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Fax | 203-932-4051
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Provider Business Mailing Address
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Address Line | 44 SARA CIR
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City | NORTH HAVEN
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State | CT
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Zip | 06473-2867
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Country | US
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Telephone | 203-889-7394
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 005557
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License Number State | CT
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