Provider Demographics
NPI:1689923948
Name:YANG, JEFF FU-LIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFF
Middle Name:FU-LIN
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 1:366 5TH AVE # 4F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2211
Mailing Address - Country:US
Mailing Address - Phone:718-290-9807
Mailing Address - Fax:
Practice Address - Street 1:2455 HYLAN BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-3146
Practice Address - Country:US
Practice Address - Phone:718-362-6680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-02
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY278692207R00000X
NJ25MA09847500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04685416Medicaid