Provider Demographics
NPI:1689640484
Name:YANG, MINGXUE (MD)
Entity Type:Individual
Prefix:
First Name:MINGXUE
Middle Name:
Last Name:YANG
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 1:1625 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3637
Mailing Address - Country:US
Mailing Address - Phone:212-369-8700
Mailing Address - Fax:
Practice Address - Street 1:1625 3RD AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3637
Practice Address - Country:US
Practice Address - Phone:212-369-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234908207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02993566OtherMEDICAID GROUP NUMBER
NY02706361Medicaid
NYI150970Medicare UPIN
MY0836E510Medicare PIN
NYG400007093Medicare PIN