Provider Demographics
NPI:1871855908
Name:NIE, YANHONG
Entity Type:Individual
Prefix:
First Name:YANHONG
Middle Name:
Last Name:NIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6911 YELLOWSTONE BLVD
Mailing Address - Street 2:A64
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3761
Mailing Address - Country:US
Mailing Address - Phone:646-272-9246
Mailing Address - Fax:
Practice Address - Street 1:2 ROOSEVELT AVE
Practice Address - Street 2:300
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-3064
Practice Address - Country:US
Practice Address - Phone:516-496-4460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14586171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator