Provider Demographics
NPI:1962814806
Name:HU, JIMMY YAN (MD)
Entity Type:Individual
Prefix:
First Name:JIMMY
Middle Name:YAN
Last Name:HU
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 1:437 5TH AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2205
Mailing Address - Country:US
Mailing Address - Phone:212-931-5110
Mailing Address - Fax:212-832-9739
Practice Address - Street 1:437 5TH AVE FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2205
Practice Address - Country:US
Practice Address - Phone:212-931-5110
Practice Address - Fax:212-832-9739
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD85226207W00000X
NY300337207WX0120X, 207W00000X, 207WX0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400255235Medicaid