Provider Demographics
NPI:1265510556
Name:SHIH, YANG CHIH (MD)
Entity Type:Individual
Prefix:
First Name:YANG
Middle Name:CHIH
Last Name:SHIH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ANDREW
Other - Middle Name:C
Other - Last Name:SHIH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:20 GRAND ST
Mailing Address - Street 2:FL 3
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1035
Mailing Address - Country:US
Mailing Address - Phone:845-357-1717
Mailing Address - Fax:845-987-5979
Practice Address - Street 1:79 ROUTE 59 STE 5
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4900
Practice Address - Country:US
Practice Address - Phone:845-357-1717
Practice Address - Fax:845-357-4819
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05004100207RI0011X
NY188912207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY37H241Medicare ID - Type Unspecified
NYE84255Medicare UPIN