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General NPI Number Information
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NPI Number | 1720314594
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Entity Type | Organization
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Legal Business Name | SHIN YU, M.D., P.C.
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Dates
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Enumeration Date | 10/28/2009
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Last Update Date | 10/28/2009
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Provider Practice Location Address
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Address Line | 6011 CATALPA AVE
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City | RIDGEWOOD
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State | NY
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Zip | 11385-5161
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Country | US
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Telephone | 718-386-4456
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Fax | 718-417-5782
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Provider Business Mailing Address
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Address Line | 1 S LAWN AVE
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City | ELMSFORD
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State | NY
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Zip | 10523-3604
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Country | US
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Telephone | 914-592-7400
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Fax | 914-592-7493
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Authorized Official
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Title or Position | PRACTITIONER/PRESIDENT
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Name | SHIN YU
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Credential | M.D.
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Telephone | 914-592-7400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 210312
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License Number State | NY
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