Individual
DR. KELLY YU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
313 6TH AVE, APT 1A, NEW YORK, NY 10014-4445
(646) 912-9322
Mailing address
313 6TH AVE, APT 1A, NEW YORK, NY 10014-4445
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
054622
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03191513
—
NY
Enumeration date
07/01/2008
Last updated
12/20/2011
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