Provider Demographics
NPI:1760770630
Name:HEE K YANG MD FACS
Entity Type:Organization
Organization Name:HEE K YANG MD FACS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HEE
Authorized Official - Middle Name:K
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-567-7747
Mailing Address - Street 1:464 HUDSON TER
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2902
Mailing Address - Country:US
Mailing Address - Phone:201-567-7747
Mailing Address - Fax:201-567-3916
Practice Address - Street 1:464 HUDSON TER
Practice Address - Street 2:101
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2902
Practice Address - Country:US
Practice Address - Phone:201-567-7747
Practice Address - Fax:201-567-3916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-13
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06687100174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF99369Medicare UPIN
NY08308Medicare PIN
NJ228845Medicare PIN