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General NPI Number Information
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NPI Number | 1912290057
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Entity Type | Organization
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Legal Business Name | NEW YORK ADVANCED CARDIAC & VASCULAR SERVICES, PC
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Dates
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Enumeration Date | 05/24/2011
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Last Update Date | 05/24/2011
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Provider Practice Location Address
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Address Line | 839 58TH ST 6TH FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11220-3679
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Country | US
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Telephone | 917-386-4799
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Fax | 212-580-7513
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Provider Business Mailing Address
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Address Line | 100 RIVERSIDE BLVD SUITE 5A
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City | NEW YORK
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State | NY
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Zip | 10069-0401
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Country | US
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Telephone | 917-386-4799
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Fax | 212-580-7513
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. YI-MING YANG
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Credential | M.D.
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Telephone | 917-386-4799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 227161
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License Number State | NY
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