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NPI Code Detail

MEDICARE: DR. HAEYOON YANG

MEDICARE: DR. HAEYOON YANG
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
11223G0001XGeneral Practice Dentistry0594131-1NY

General Provider Information

NPI Number : 1265972616
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HAEYOON YANG
Provider Business Mailing Address
First Line : 31 E 31ST ST PH E
Second Line :
City : NEW YORK
State : NY
Zip : 10016-6824
Country : US
Telephone Number : 267-736-6722
Fax Number :
Provider Business Practice Location Address
First Line : 8618 37TH AVE
Second Line :
City : JACKSON HEIGHTS
State : NY
Zip : 11372-7533
Country : US
Telephone Number : 718-963-7174
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2017
Last Update Date : 10/10/2018

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