Provider Demographics
NPI:1699161968
Name:QIAN, YU
Entity type:Individual
Prefix:
First Name:YU
Middle Name:
Last Name:QIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4237 GLEANE ST
Mailing Address - Street 2:APT 3
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-2748
Mailing Address - Country:US
Mailing Address - Phone:646-266-2435
Mailing Address - Fax:
Practice Address - Street 1:4237 GLEANE ST
Practice Address - Street 2:APT 3
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-2748
Practice Address - Country:US
Practice Address - Phone:646-266-2435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3198201164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse