Provider Demographics
NPI:1366887739
Name:YU, SARAH (LAC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:YU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6500 JERICHO TURNPIKE SUITE 218
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725
Mailing Address - Country:US
Mailing Address - Phone:631-804-7538
Mailing Address - Fax:
Practice Address - Street 1:6500 JERICHO TPKE STE 218
Practice Address - Street 2:SUITE218
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-2907
Practice Address - Country:US
Practice Address - Phone:631-804-7538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-30
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004316171100000X
NY4316171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist