Provider Demographics
NPI:1417555202
Name:YONG, ANGIE (AGNP-C, MPH, MSN)
Entity type:Individual
Prefix:
First Name:ANGIE
Middle Name:
Last Name:YONG
Suffix:
Gender:
Credentials:AGNP-C, MPH, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:757 60TH ST STE 5
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-5490
Mailing Address - Country:US
Mailing Address - Phone:718-439-3250
Mailing Address - Fax:
Practice Address - Street 1:757 60TH ST STE 5
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-5490
Practice Address - Country:US
Practice Address - Phone:718-439-3250
Practice Address - Fax:718-492-4575
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF311956363LA2200X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health