Basic Information
Provider Information
NPI: 1134357775
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YU
FirstName: KARL OLIVER
MiddleName: ANG
NamePrefix: DR.
NameSuffix:  
Credential: M.D., PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1001 MAIN ST FL 5
Address2:  
City: BUFFALO
State: NY
PostalCode: 142031009
CountryCode: US
TelephoneNumber: 7163230150
FaxNumber: 7163230296
Practice Location
Address1: 1001 MAIN ST FL 5
Address2:  
City: BUFFALO
State: NY
PostalCode: 142031009
CountryCode: US
TelephoneNumber: 7163230150
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/22/2009
LastUpdateDate: 10/18/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X253588NYN Allopathic & Osteopathic PhysiciansPediatrics 
2080P0208X036128197ILN Allopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
2080P0208X253588NYY Allopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases

No ID Information.


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