MEDICARE: JENNY YANG LAC, DACM

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	171100000X	Acupuncturist	006445-1	NY

General Provider Information

NPI Number	:	1215593124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNY YANG LAC, DACM

Provider Business Mailing Address
First Line	:	8834 69TH AVE
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-6606
Country	:	US
Telephone Number	:	917-515-9168
Fax Number	:

Provider Business Practice Location Address
First Line	:	8834 69TH AVE
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-6606
Country	:	US
Telephone Number	:	917-515-9168
Fax Number	:

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

Provider Enumeration Date	:	05/15/2019
Last Update Date	:	05/15/2019

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