MEDICARE: MARIA THERESA 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	164W00000X	Licensed Practical Nurse	328077	NY

General Provider Information

NPI Number	:	1366338303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA THERESA YEN

Provider Business Mailing Address
First Line	:	52 EDGEHILL DR
Second Line	:
City	:	WAPPINGERS FALLS
State	:	NY
Zip	:	12590-3628
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	52 EDGEHILL DR
Second Line	:
City	:	WAPPINGERS FALLS
State	:	NY
Zip	:	12590-3628
Country	:	US
Telephone Number	:	845-527-8805
Fax Number	:

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

Provider Enumeration Date	:	06/16/2025
Last Update Date	:	06/16/2025

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