1154654044 NPI number — KEN YU, ANESTHESIOLOGISTS,P.C.

Table of content: (NPI 1154654044)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154654044 NPI number — KEN YU, ANESTHESIOLOGISTS,P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KEN YU, ANESTHESIOLOGISTS,P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1154654044
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/10/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1964 STATE ST
Provider Second Line Business Mailing Address:
SUITE #206
Provider Business Mailing Address City Name:
NEW ALBANY
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47150-4934
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-949-9918
Provider Business Mailing Address Fax Number:
812-941-0289

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1964 STATE ST
Provider Second Line Business Practice Location Address:
SUITE #206
Provider Business Practice Location Address City Name:
NEW ALBANY
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47150-4934
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-949-9918
Provider Business Practice Location Address Fax Number:
812-941-0289
Provider Enumeration Date:
09/10/2009

Additional Information

Authorized Official

Authorized Official Last Name:
YU
Authorized Official First Name:
KEN
Authorized Official Middle Name:
K
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
812-949-9918

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 100116230A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com