MEDICARE: CHRISTINE 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
1	225X00000X	Occupational Therapist	09786	MD
2	225X00000X	Occupational Therapist	0119007226	VA

General Provider Information

NPI Number	:	1780308957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE YANG

Provider Business Mailing Address
First Line	:	3201 LANDOVER ST APT 1102
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22305-1926
Country	:	US
Telephone Number	:	201-390-5175
Fax Number	:

Provider Business Practice Location Address
First Line	:	3201 LANDOVER ST APT 1102
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22305-1926
Country	:	US
Telephone Number	:	201-390-5175
Fax Number	:

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

Provider Enumeration Date	:	09/30/2022
Last Update Date	:	09/30/2022

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Directions to “ CHRISTINE YANG ” Practice Location

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