Provider Demographics
NPI:1083175038
Name:YANGGA, PETER HANS (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:HANS
Last Name:YANGGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 W 36TH ST, FLOOR 6
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018
Mailing Address - Country:US
Mailing Address - Phone:212-786-7727
Mailing Address - Fax:646-638-1440
Practice Address - Street 1:525 W 36TH ST, FLOOR 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018
Practice Address - Country:US
Practice Address - Phone:212-786-7727
Practice Address - Fax:646-638-1440
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-30
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY328209207RI0200X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease