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General NPI Number Information
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NPI Number | 1710432117
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Entity Type | Organization
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Legal Business Name | TAO INSTITUTE OF MIND & BODY MEDICINE -BRYN MAWR, PC
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Dates
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Enumeration Date | 08/16/2016
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Last Update Date | 08/16/2016
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Provider Practice Location Address
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Address Line | 940 E HAVERFORD RD SUITE 201
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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 | 610-520-1331
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Provider Business Mailing Address
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Address Line | 940 E HAVERFORD RD SUITE 201
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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 | 610-520-1331
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JINGDUAN YANG
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Credential | M.D.
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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 | MD422505
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License Number State | PA
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