Provider Demographics
NPI:1225590920
Name:YU, YANG
Entity Type:Individual
Prefix:
First Name:YANG
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 W MICHIGAN ST # CL630
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5209
Mailing Address - Country:US
Mailing Address - Phone:317-278-2689
Mailing Address - Fax:317-278-2650
Practice Address - Street 1:STETSON BUILDING SUITE 2300
Practice Address - Street 2:260 STETSON STREET
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45267-0525
Practice Address - Country:US
Practice Address - Phone:513-558-2968
Practice Address - Fax:513-558-4887
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program