Provider Demographics
NPI:1083000962
Name:YANG, GRACE HAECHUNG (MD)
Entity type:Individual
Prefix:DR
First Name:GRACE
Middle Name:HAECHUNG
Last Name:YANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 MEADOWLANDS PKWY
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-2925
Mailing Address - Country:US
Mailing Address - Phone:201-293-0401
Mailing Address - Fax:201-293-0402
Practice Address - Street 1:38 MEADOWLANDS PKWY
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-2925
Practice Address - Country:US
Practice Address - Phone:201-293-0401
Practice Address - Fax:201-293-0402
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-08
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10623100207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty