Provider Demographics
NPI:1326001991
Name:YU, YONG MAX (MD)
Entity type:Individual
Prefix:DR
First Name:YONG
Middle Name:MAX
Last Name:YU
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13620 38TH AVE STE 8C
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4232
Mailing Address - Country:US
Mailing Address - Phone:718-886-6995
Mailing Address - Fax:929-900-1699
Practice Address - Street 1:13620 38TH AVE STE 8C
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4232
Practice Address - Country:US
Practice Address - Phone:718-886-6995
Practice Address - Fax:929-900-1699
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207098207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01825465Medicaid
NY01825465Medicaid
NYG61065Medicare UPIN