MEDICARE: DING CHENG YANG DPM 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	213ES0103X	Foot & Ankle Surgery Podiatrist	N006265	NY

General Provider Information

NPI Number	:	1770894917
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DING CHENG YANG DPM PLLC

Provider Business Mailing Address
First Line	:	66 ZACHARY CT
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10310-2672
Country	:	US
Telephone Number	:	347-238-5723
Fax Number	:	718-273-4804

Provider Business Practice Location Address
First Line	:	66 ZACHARY CT
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10310-2672
Country	:	US
Telephone Number	:	347-238-5723
Fax Number	:	718-273-4804

Authorized Official
Title or Position	:	DPM
Name	:	DING C YANG
Credential	:
Telephone Number	:	347-238-5723

Provider Enumeration Date	:	06/22/2010
Last Update Date	:	06/22/2010

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