Basic Information
| Provider Information | |||||||||
| NPI: | 1225435092 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GUO | ||||||||
| FirstName: | YANLI | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13820 31ST RD APT 3A | ||||||||
| Address2: | |||||||||
| City: | FLUSHING | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113542102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6462446893 | ||||||||
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| Practice Location | |||||||||
| Address1: | 234 EUGENIO MARIA DE HOSTO BLVD | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104515504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185795000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2014 | ||||||||
| LastUpdateDate: | 11/29/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 018269 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.