MEDICARE: DR. YANG MEDICAL OFFICE PLLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	269821	NY

General Provider Information

NPI Number	:	1447662614
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. YANG MEDICAL OFFICE PLLC

Provider Business Mailing Address
First Line	:	7016 HARROW ST
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-5154
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7016 HARROW ST
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-5154
Country	:	US
Telephone Number	:	917-859-5536
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. YU YANG
Credential	:	M.D.
Telephone Number	:	917-859-5536

Provider Enumeration Date	:	05/22/2014
Last Update Date	:	05/22/2014

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