Provider Demographics
NPI:1669627147
Name:GUI, YANG (LAC)
Entity Type:Individual
Prefix:MR
First Name:YANG
Middle Name:
Last Name:GUI
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 BEACH 81ST ST
Mailing Address - Street 2:5G
Mailing Address - City:ROCKAWAY BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11693-1902
Mailing Address - Country:US
Mailing Address - Phone:718-415-2331
Mailing Address - Fax:
Practice Address - Street 1:260 BEACH 81ST ST
Practice Address - Street 2:5G
Practice Address - City:ROCKAWAY BEACH
Practice Address - State:NY
Practice Address - Zip Code:11693-1902
Practice Address - Country:US
Practice Address - Phone:718-415-2331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002524171100000X
PAKO000083L171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist