Provider Demographics
NPI:1558543611
Name:YAN, ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:YAN
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 1:5 ULENSKI DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-1103
Mailing Address - Country:US
Mailing Address - Phone:518-724-2444
Mailing Address - Fax:518-724-2445
Practice Address - Street 1:5 ULENSKI DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-1103
Practice Address - Country:US
Practice Address - Phone:518-724-2444
Practice Address - Fax:518-724-2445
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2593282086S0122X
NY2540542086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery