=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740203520
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHENG HUAN YE MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/25/2006
-----------------------------------------------------
Last Update Date | 06/15/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 370 GRAND AVE STE 102
-----------------------------------------------------
City | ENGLEWOOD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07631-4109
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-567-3370
-----------------------------------------------------
Fax | 201-816-1265
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 370 GRAND AVE STE 102
-----------------------------------------------------
City | ENGLEWOOD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07631-4109
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-567-3370
-----------------------------------------------------
Fax | 201-816-1265
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 25MA06781100
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------