Provider Demographics
NPI:1588251698
Name:YANG, LILY (APN)
Entity type:Individual
Prefix:
First Name:LILY
Middle Name:
Last Name:YANG
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 HOOK MOUNTAIN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PINE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07058-9462
Mailing Address - Country:US
Mailing Address - Phone:973-317-8510
Mailing Address - Fax:
Practice Address - Street 1:18 HOOK MOUNTAIN RD STE 200
Practice Address - Street 2:
Practice Address - City:PINE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07058-9462
Practice Address - Country:US
Practice Address - Phone:973-317-8510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-22
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01088700363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health