Provider Demographics
NPI:1427441211
Name:YUNG, LAU YAN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:LAU YAN
Middle Name:
Last Name:YUNG
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 WEST 168TH STREET
Mailing Address - Street 2:BOX 4
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3725
Mailing Address - Country:US
Mailing Address - Phone:212-305-1454
Mailing Address - Fax:212-305-3213
Practice Address - Street 1:622 W 168TH ST
Practice Address - Street 2:PH-10-313
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-305-1454
Practice Address - Fax:212-305-3213
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-18
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306948363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health