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Individual

IN SOON YANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7901 BROADWAY, MANAGE CARE D1-01, ELMHURST, NY 11373-1329
(718) 334-3513
(718) 334-3513
Mailing address
7901 BROADWAY, MANAGE CARE D1-01, ELMHURST, NY 11373-1329
(718) 334-3513
(718) 334-3513

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
F334305
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F401882-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02163642
NY
Enumeration date
11/18/2006
Last updated
10/31/2016
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