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General NPI Number Information
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NPI Number | 1447924329
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Entity Type | Individual
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Provider Name | KEYING YAN OD
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Gender | Female
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Dates
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Enumeration Date | 08/04/2021
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Last Update Date | 07/13/2022
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Provider Practice Location Address
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Address Line | 1705 WARREN AVE STE 303
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-2665
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Country | US
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Telephone | 570-320-7850
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 GRAMPIAN BLVD
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-1900
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Country | US
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Telephone |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 009356
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG003885
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License Number State | PA
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