Provider Demographics
NPI:1417104803
Name:YBLWELLNESS MANAGEMENT INC
Entity Type:Organization
Organization Name:YBLWELLNESS MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:LIANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-966-0819
Mailing Address - Street 1:55 CHRYSTIE ST
Mailing Address - Street 2:SUITE 407
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-5055
Mailing Address - Country:US
Mailing Address - Phone:212-966-0819
Mailing Address - Fax:212-334-6816
Practice Address - Street 1:55 CHRYSTIE ST
Practice Address - Street 2:SUITE 407
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-5042
Practice Address - Country:US
Practice Address - Phone:212-966-0819
Practice Address - Fax:212-334-6816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2174192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty