Provider Demographics
NPI:1962928986
Name:OUYANG, AIMIN (RPA-C)
Entity type:Individual
Prefix:
First Name:AIMIN
Middle Name:
Last Name:OUYANG
Suffix:
Gender:M
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5521 8TH AVE UNIT 3C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-3515
Mailing Address - Country:US
Mailing Address - Phone:718-437-3855
Mailing Address - Fax:
Practice Address - Street 1:5521 8TH AVE UNIT 3C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3515
Practice Address - Country:US
Practice Address - Phone:718-437-3855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020940363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY830091165OtherDRIVER LICENSE