1861827610 NPI number — LIHYANG YU L.AC

Table of content: LIHYANG YU L.AC (NPI 1861827610)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861827610 NPI number — LIHYANG YU L.AC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YU
Provider First Name:
LIHYANG
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
L.AC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861827610
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/08/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
45 E CENTRAL BLVD
Provider Second Line Business Mailing Address:
UNIT A
Provider Business Mailing Address City Name:
PALISADES PARK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07650
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-815-7070
Provider Business Mailing Address Fax Number:
201-585-7070

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 ROCKLAND PARK AVE UNIT C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAPPAN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10983-2617
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-815-7070
Provider Business Practice Location Address Fax Number:
201-585-7070
Provider Enumeration Date:
09/12/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  005039 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)