Provider Demographics
NPI:1336335348
Name:YANG, BER-YUH MEDICAL PRACTICE, PC
Entity Type:Organization
Organization Name:YANG, BER-YUH MEDICAL PRACTICE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BER-YUH
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-539-8483
Mailing Address - Street 1:13511 40TH RD STE 3D
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5329
Mailing Address - Country:US
Mailing Address - Phone:718-539-8483
Mailing Address - Fax:718-539-8422
Practice Address - Street 1:13511 40TH RD STE 3D
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5330
Practice Address - Country:US
Practice Address - Phone:718-539-8483
Practice Address - Fax:718-539-8422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY195503207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01750238Medicaid
NY03290Medicare PIN