Basic Information
| Provider Information | |||||||||
| NPI: | 1982756656 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YA | ||||||||
| FirstName: | AUNG | ||||||||
| MiddleName: | ZE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 144 45 87TH AVENUE | ||||||||
| Address2: | SILVERCREST CENTER FOR NURSING & REH | ||||||||
| City: | BRIARWOOD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114353109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184804026 | ||||||||
| FaxNumber: | 7184804028 | ||||||||
| Practice Location | |||||||||
| Address1: | 144 45 87TH AVENUE | ||||||||
| Address2: | SILVERCREST CENTER FOR NURSING & REH | ||||||||
| City: | BRIARWOOD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114353109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184804026 | ||||||||
| FaxNumber: | 7184804028 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0300X | 23814301 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
ID Information
| ID | Type | State | Issuer | Description | 23814301 | 01 | NY | NYS MEDICAL LICENSE | OTHER | 02624371 | 05 | NY | MEDICAID |