MEDICARE: DR. EDDIE W. 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	208000000X	Pediatrics Physician	228410	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235166794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDDIE W. YANG M.D.

Provider Business Mailing Address
First Line	:	11 E BROADWAY STE 12B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10038-1013
Country	:	US
Telephone Number	:	212-374-1103
Fax Number	:	212-374-1109

Provider Business Practice Location Address
First Line	:	11 E BROADWAY STE 12B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10038-1013
Country	:	US
Telephone Number	:	212-374-1103
Fax Number	:	212-374-1109

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	11/10/2025

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Directions to “ DR. EDDIE W. YANG M.D.” Practice Location

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