Provider Demographics
NPI:1396724456
Name:YUAN, LIANG (MD)
Entity type:Individual
Prefix:DR
First Name:LIANG
Middle Name:
Last Name:YUAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 HARTFORD ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02461-1553
Mailing Address - Country:US
Mailing Address - Phone:617-331-9940
Mailing Address - Fax:617-795-2402
Practice Address - Street 1:4 HARTFORD ST
Practice Address - Street 2:202
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02461-1553
Practice Address - Country:US
Practice Address - Phone:617-331-9940
Practice Address - Fax:617-795-2402
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2132682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA320678232OtherUBH
MA464140OtherTUFTS HEALTH PLAN
MA433300OtherUNITED HEALTH CARE
MA7191784OtherAETNA
MAJ26522OtherBC/BS
MA2010470Medicaid
MAJ26522OtherBC/BS
MA320678232OtherUBH