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General NPI Number Information
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NPI Number | 1417104803
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Entity Type | Organization
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Legal Business Name | YBLWELLNESS MANAGEMENT INC
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Dates
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Enumeration Date | 08/27/2008
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Last Update Date | 08/27/2008
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Provider Practice Location Address
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Address Line | 55 CHRYSTIE ST SUITE 407
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City | NEW YORK
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State | NY
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Zip | 10002-5042
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Country | US
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Telephone | 212-966-0819
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Fax | 212-334-6816
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Provider Business Mailing Address
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Address Line | 55 CHRYSTIE ST SUITE 407
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City | NEW YORK
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State | NY
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Zip | 10002-5055
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Country | US
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Telephone | 212-966-0819
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Fax | 212-334-6816
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Authorized Official
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Title or Position | MANAGER
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Name | DR. LAWRENCE Y LIANG
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Credential | MD
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Telephone | 212-966-0819
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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 | 217419
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License Number State | NY
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