Provider Demographics
NPI:1588007413
Name:YANLIANG SUN MEDICAL PLLC
Entity Type:Organization
Organization Name:YANLIANG SUN MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE
Authorized Official - Prefix:
Authorized Official - First Name:YANGLIANG
Authorized Official - Middle Name:
Authorized Official - Last Name:SUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-488-6069
Mailing Address - Street 1:4160 MAIN ST
Mailing Address - Street 2:SUITE 312
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3833
Mailing Address - Country:US
Mailing Address - Phone:718-463-6868
Mailing Address - Fax:
Practice Address - Street 1:41-60 MAIN ST
Practice Address - Street 2:STE 312
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-463-6868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY254007207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03542023Medicaid