Provider Demographics
NPI:1093709719
Name:YEN, CONCEPCION TAN (MD)
Entity Type:Individual
Prefix:
First Name:CONCEPCION
Middle Name:TAN
Last Name:YEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 W JONATHAN ST
Mailing Address - Street 2:STE 101
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-3170
Mailing Address - Country:US
Mailing Address - Phone:610-432-2706
Mailing Address - Fax:610-432-0775
Practice Address - Street 1:1728 W JONATHAN ST
Practice Address - Street 2:STE 101
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-3170
Practice Address - Country:US
Practice Address - Phone:610-432-2706
Practice Address - Fax:610-432-0775
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-08
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA030194L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
01051301OtherCAPITAL BLUE CROSS
0040188000OtherKEYSTONE EAST
0000459987OtherAMERIHEALTH ADMIN
UE018138OtherRAILROAD MEDICARE
YE0000459987OtherPA BLUE SHIELD
0000063560OtherAETNA
0001003087OtherKEYSTONE MERCY
018138OtherIBC PERSONAL CHOICE
0228095001OtherUNITED HEALTHCARE
0000459987OtherKEYSTONE
0000459987OtherSENIOR BLUE
0001003087OtherAMERIHEALTH MERCY
0007459987OtherGATEWAY
29257OtherGELSINGER HEALTH PLAN
0000459987OtherKEYSTONE
PA018138Medicare PIN