Basic Information
| Provider Information | |||||||||
| NPI: | 1659397602 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YUEN | ||||||||
| FirstName: | JEANNETTE | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 259 HEATHCOTE RD | ||||||||
| Address2: | |||||||||
| City: | SCARSDALE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105834523 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147238100 | ||||||||
| FaxNumber: | 9147229185 | ||||||||
| Practice Location | |||||||||
| Address1: | 259 HEATHCOTE RD | ||||||||
| Address2: | |||||||||
| City: | SCARSDALE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105834523 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147238100 | ||||||||
| FaxNumber: | 9147229185 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2006 | ||||||||
| LastUpdateDate: | 05/26/2011 | ||||||||
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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 | 207RC0000X | 188962 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 01622595 | 05 | NY | MEDICAID |