1740453620 NPI number — DR. ELIZABETH Y YEU-LIN MD

Table of content: DR. ELIZABETH Y YEU-LIN MD (NPI 1740453620)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740453620 NPI number — DR. ELIZABETH Y YEU-LIN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YEU-LIN
Provider First Name:
ELIZABETH
Provider Middle Name:
Y
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LIN
Provider Other First Name:
ELIZABETH
Provider Other Middle Name:
YEU
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1740453620
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/20/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
241 CORPORATE BLVD. STE. 210
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORFOLK
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23502
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-622-2200
Provider Business Mailing Address Fax Number:
757-965-9493

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
241 CORPORATE BLVD
Provider Second Line Business Practice Location Address:
STE. 210
Provider Business Practice Location Address City Name:
NORFOLK
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-622-2200
Provider Business Practice Location Address Fax Number:
757-965-9493
Provider Enumeration Date:
04/10/2008

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: 207W00000X , with the licence number:  0101253475 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1740453620 . This is a "TRICARE/TRICARE FOR LIFE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 489220 . This is a "ANTHEM BCBS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: P01179585 . This is a "RR MEDICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1740453620 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10107980 . This is a "OPTIMA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com