Provider Demographics
NPI:1740345669
Name:RAYMOND L YUNG MD PC
Entity type:Organization
Organization Name:RAYMOND L YUNG MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:L
Authorized Official - Last Name:YUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-625-8069
Mailing Address - Street 1:217 GRAND STREET
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4223
Mailing Address - Country:US
Mailing Address - Phone:212-625-8069
Mailing Address - Fax:212-431-8246
Practice Address - Street 1:217 GRAND STREET
Practice Address - Street 2:6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4223
Practice Address - Country:US
Practice Address - Phone:212-625-8069
Practice Address - Fax:212-431-8246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1855781207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4655590OtherAETNA
NY185578A31Other1199
NY228239OtherWELLCARE
NY9422652011OtherCIGNA
NY01888215Medicaid
NY0600362OtherGHI
NY177890101OtherHEALTHPLUS
NMYR5578OtherATLANTIS
NY03325835Medicaid
NY08Z031OtherEMPIRE BCBS
NY185578-C20OtherHEALTH FIRST
NY2200742OtherAETNA
NY2C7453OtherHEALTH NET
NY1000036961OtherAFFINITY
NY1001268197(01)OtherAMERICHOICE
NYCS1040OtherOXFORD
NY177890101OtherHEALTHPLUS
NY2C7453OtherHEALTH NET
NY01888215Medicaid