MEDICARE: YU YANG M.D.

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	2084P0800X	Psychiatry Physician	269821	NY

General Provider Information

NPI Number	:	1104260611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YU YANG M.D.

Provider Business Mailing Address
First Line	:	7016 HARROW ST
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-5154
Country	:	US
Telephone Number	:	917-859-5536
Fax Number	:

Provider Business Practice Location Address
First Line	:	11045 QUEENS BLVD STE 110
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-5519
Country	:	US
Telephone Number	:	191-785-9553
Fax Number	:	917-859-5536

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

Provider Enumeration Date	:	04/26/2013
Last Update Date	:	01/06/2018

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