Provider Demographics
NPI:1790973774
Name:CHI, YONG (MD)
Entity Type:Individual
Prefix:DR
First Name:YONG
Middle Name:
Last Name:CHI
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 1:13876 QUEENS BLVD
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BRIARWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11435-2930
Mailing Address - Country:US
Mailing Address - Phone:718-850-6345
Mailing Address - Fax:718-559-4895
Practice Address - Street 1:136 - 04 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354
Practice Address - Country:US
Practice Address - Phone:718-886-8386
Practice Address - Fax:718-886-8585
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243073-1208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation