MEDICARE: DR. HENRY C YU M.D.

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	208000000X	Pediatrics Physician	NY144251	NY

General Provider Information

NPI Number	:	1972633048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HENRY C YU M.D.

Provider Business Mailing Address
First Line	:	15 BOLTON DR
Second Line	:
City	:	MANHASSET
State	:	NY
Zip	:	11030-3942
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	432 MYRTLE AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11205-2402
Country	:	US
Telephone Number	:	718-834-1116
Fax Number	:

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

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	07/08/2007

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