MEDICARE: CAMERON JAMES YUEN PT, DPT, CSCS

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	2251X0800X	Orthopedic Physical Therapist	042551	NY

General Provider Information

NPI Number	:	1831602945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMERON JAMES YUEN PT, DPT, CSCS

Provider Business Mailing Address
First Line	:	78 MANHATTAN AVE APT 3F
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10025-4665
Country	:	US
Telephone Number	:	858-736-4704
Fax Number	:

Provider Business Practice Location Address
First Line	:	295 MADISON AVE RM 1826
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-6337
Country	:	US
Telephone Number	:	646-596-7427
Fax Number	:

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

Provider Enumeration Date	:	11/10/2017
Last Update Date	:	11/10/2017

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