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NPI Code Detail

MEDICARE: MR. YOUNGSUN JYANG PA-C

MEDICARE:  MR. YOUNGSUN  JYANG  PA-C
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
1363A00000XPhysician Assistant1138802

General Provider Information

NPI Number : 1245777473
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. YOUNGSUN JYANG PA-C
Provider Business Mailing Address
First Line : 2133 MARQUEE LN
Second Line :
City : FUQUAY VARINA
State : NC
Zip : 27526-3207
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2133 MARQUEE LN
Second Line :
City : FUQUAY VARINA
State : NC
Zip : 27526-3207
Country : US
Telephone Number : 516-965-7801
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2017
Last Update Date : 01/25/2017

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Directions to “ MR. YOUNGSUN JYANG PA-C” Practice Location

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