Provider Demographics
NPI:1811209067
Name:YU, YANJIE (RD, CDN)
Entity Type:Individual
Prefix:
First Name:YANJIE
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5945 161ST ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11365-1414
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5945 161ST ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11365-1414
Practice Address - Country:US
Practice Address - Phone:718-762-3111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-04
Last Update Date:2010-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006941133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered