Provider Demographics
NPI:1700344314
Name:YU, ELIZABETH J (ATC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:J
Last Name:YU
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 COTTONWOOD BUILDING
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17057-2504
Mailing Address - Country:US
Mailing Address - Phone:410-660-1731
Mailing Address - Fax:
Practice Address - Street 1:2913 SPOOKY NOOK RD STE 100
Practice Address - Street 2:
Practice Address - City:MANHEIM
Practice Address - State:PA
Practice Address - Zip Code:17545-9149
Practice Address - Country:US
Practice Address - Phone:717-299-4871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-04
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program