Provider Demographics
NPI:1124259601
Name:SUN, YANLIANG (MD)
Entity type:Individual
Prefix:MRS
First Name:YANLIANG
Middle Name:
Last Name:SUN
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 1:11118 66TH AVE
Mailing Address - Street 2:#2A
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-1921
Mailing Address - Country:US
Mailing Address - Phone:718-459-0873
Mailing Address - Fax:
Practice Address - Street 1:375 GRAND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-3951
Practice Address - Country:US
Practice Address - Phone:212-260-3640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-02
Last Update Date:2009-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY254007207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine