Provider Demographics
NPI:1831642180
Name:LEE YAW, SHAWN (NP)
Entity Type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:
Last Name:LEE YAW
Suffix:
Gender:M
Credentials:NP
Other - Prefix:MR
Other - First Name:SHAWN
Other - Middle Name:
Other - Last Name:LEE YAW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:242 NEW YORK AVE
Mailing Address - Street 2:APT 3R
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-4336
Mailing Address - Country:US
Mailing Address - Phone:347-678-5738
Mailing Address - Fax:
Practice Address - Street 1:1300 YORK AVE # C-650
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4805
Practice Address - Country:US
Practice Address - Phone:212-746-5867
Practice Address - Fax:212-746-8866
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF340437-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily