Provider Demographics
NPI:1508938655
Name:YUEN, YIN YIN (OD)
Entity Type:Individual
Prefix:
First Name:YIN YIN
Middle Name:
Last Name:YUEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PELHAM RD
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-2408
Mailing Address - Country:US
Mailing Address - Phone:617-549-2816
Mailing Address - Fax:
Practice Address - Street 1:30 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:MA
Practice Address - Zip Code:02322-1919
Practice Address - Country:US
Practice Address - Phone:508-587-8391
Practice Address - Fax:508-587-5317
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4237152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0335169Medicaid
MAYU W17415Medicare ID - Type Unspecified
MA0335169Medicaid