Provider Demographics
NPI:1922111954
Name:YU-TANG, CHIN HSIEN (NP)
Entity Type:Individual
Prefix:MRS
First Name:CHIN
Middle Name:HSIEN
Last Name:YU-TANG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 BROADWAY # A1-19
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1329
Mailing Address - Country:US
Mailing Address - Phone:718-334-2488
Mailing Address - Fax:718-334-5006
Practice Address - Street 1:7901 BROADWAY # A1-19
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1329
Practice Address - Country:US
Practice Address - Phone:718-334-2488
Practice Address - Fax:718-334-5006
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF302865-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02080817Medicaid
83-00074OtherEVERCARE
S94410Medicare UPIN
83-00074OtherEVERCARE