MEDICARE: MR. SHAWN LEE YAW NP

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	363LF0000X	Family Nurse Practitioner	F340437-1	NY

General Provider Information

NPI Number	:	1831642180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SHAWN LEE YAW NP

Provider Business Mailing Address
First Line	:	242 NEW YORK AVE
Second Line	:	APT 3R
City	:	BROOKLYN
State	:	NY
Zip	:	11216-4336
Country	:	US
Telephone Number	:	347-678-5738
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 YORK AVE # C-650
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10065-4805
Country	:	US
Telephone Number	:	212-746-5867
Fax Number	:	212-746-8866

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

Provider Enumeration Date	:	08/03/2016
Last Update Date	:	08/03/2016

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