Provider Demographics
NPI:1629416664
Name:GU, YONGPENG (MD)
Entity Type:Individual
Prefix:
First Name:YONGPENG
Middle Name:
Last Name:GU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:83 SOMERSET DR S
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11020-1821
Mailing Address - Country:US
Mailing Address - Phone:917-563-1697
Mailing Address - Fax:917-563-1804
Practice Address - Street 1:13668 ROOSEVELT AVE STE 4C
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5510
Practice Address - Country:US
Practice Address - Phone:917-563-1697
Practice Address - Fax:917-563-1804
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2019-09-21
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Provider Licenses
StateLicense IDTaxonomies
NY270433208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology