Individual
DR. CORNELIUS LISEN YEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
13630 MAPLE AVE STE 2E, FLUSHING, NY 11355-3867
(718) 358-1200
Mailing address
13630 MAPLE AVE, STE 2E, FLUSHING, NY 11355-3867
(718) 358-1200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
053896
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03026395
—
NY
Enumeration date
07/17/2008
Last updated
11/22/2022
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