Provider Demographics
NPI:1003844077
Name:YANG, LEI (L AC)
Entity Type:Individual
Prefix:MR
First Name:LEI
Middle Name:
Last Name:YANG
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:42 SWEETBROOK RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-2439
Mailing Address - Country:US
Mailing Address - Phone:917-696-1000
Mailing Address - Fax:866-753-1668
Practice Address - Street 1:6417 18TH AVE FL 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-3753
Practice Address - Country:US
Practice Address - Phone:917-696-1000
Practice Address - Fax:866-753-1668
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000706171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist