MEDICARE: OWEN YEN

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	207RC0000X	Cardiovascular Disease Physician	146883	NY

General Provider Information

NPI Number	:	1124111232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OWEN YEN

Provider Business Mailing Address
First Line	:	45 ROUTE 25A
Second Line	:	SUITE C
City	:	SHOREHAM
State	:	NY
Zip	:	11786-1389
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	45 ROUTE 25A
Second Line	:	SUITE C
City	:	SHOREHAM
State	:	NY
Zip	:	11786-1389
Country	:	US
Telephone Number	:	631-744-3303
Fax Number	:

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

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	06/28/2023

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Directions to “ OWEN YEN ” Practice Location

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