MEDICARE: MS. ELIZABETH ANNE YING M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	6552348	NY

General Provider Information

NPI Number	:	1033346432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH ANNE YING M.A.

Provider Business Mailing Address
First Line	:	432 E 88TH ST APT 205-06
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-6603
Country	:	US
Telephone Number	:	646-438-7840
Fax Number	:	646-438-7809

Provider Business Practice Location Address
First Line	:	432 E 88TH ST APT 205-06
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-6603
Country	:	US
Telephone Number	:	646-438-7840
Fax Number	:	646-438-7809

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2009
Last Update Date	:	06/12/2009

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