Basic Information
| Provider Information | |||||||||
| NPI: | 1245461524 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YANG | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 WATERS PL | ||||||||
| Address2: | SUITE M103 | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104612728 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187941549 | ||||||||
| FaxNumber: | 7187941619 | ||||||||
| Practice Location | |||||||||
| Address1: | 1825 EASTCHESTER RD | ||||||||
| Address2: | 4TH FLOOR- ENDOSCOPY | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104612301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189042376 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2009 | ||||||||
| LastUpdateDate: | 01/29/2012 | ||||||||
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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 | 207R00000X | 4301096169 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0100X | 2532222 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207RG0100X | 25MA08600800 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207RG0100X | 4301096169 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.