Provider Demographics
NPI:1225146939
Name:YANG, IAN YENG (MD)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:YENG
Last Name:YANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 EAST 205TH ST.
Mailing Address - Street 2:FLOOR C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458
Mailing Address - Country:US
Mailing Address - Phone:718-562-2200
Mailing Address - Fax:718-562-2194
Practice Address - Street 1:174 EAST 205TH ST.
Practice Address - Street 2:FLOOR C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458
Practice Address - Country:US
Practice Address - Phone:718-562-2200
Practice Address - Fax:718-562-2194
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199659-1207L00000X, 207LP2900X
NY199659208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01900247Medicaid
NY01900247Medicaid
NY01900247Medicaid