Provider Demographics
NPI:1720314594
Name:SHIN YU, M.D., P.C.
Entity Type:Organization
Organization Name:SHIN YU, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTITIONER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-592-7400
Mailing Address - Street 1:1 S LAWN AVE
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-3604
Mailing Address - Country:US
Mailing Address - Phone:914-592-7400
Mailing Address - Fax:914-592-7493
Practice Address - Street 1:6011 CATALPA AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-5161
Practice Address - Country:US
Practice Address - Phone:718-386-4456
Practice Address - Fax:718-417-5782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210312207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty