Provider Demographics
NPI:1396057253
Name:MA, YANQING
Entity type:Individual
Prefix:
First Name:YANQING
Middle Name:
Last Name:MA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13620 MAPLE AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5167
Mailing Address - Country:US
Mailing Address - Phone:718-886-7998
Mailing Address - Fax:718-886-7978
Practice Address - Street 1:13620 MAPLE AVE STE 203
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5167
Practice Address - Country:US
Practice Address - Phone:718-886-7998
Practice Address - Fax:718-886-7978
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY271378207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine