Provider Demographics
NPI:1255126009
Name:YEUNG, KEEL (OD)
Entity type:Individual
Prefix:
First Name:KEEL
Middle Name:
Last Name:YEUNG
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 MOTT ST STE 408
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-5588
Mailing Address - Country:US
Mailing Address - Phone:212-732-0073
Mailing Address - Fax:
Practice Address - Street 1:128 MOTT ST STE 408
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-5588
Practice Address - Country:US
Practice Address - Phone:212-732-0073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program