Provider Demographics
NPI:1750016275
Name:YUE, AUDREY JANE (OD)
Entity type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:JANE
Last Name:YUE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 W 60TH ST APT 4J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7506
Mailing Address - Country:US
Mailing Address - Phone:917-880-7936
Mailing Address - Fax:
Practice Address - Street 1:213 W 79TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6241
Practice Address - Country:US
Practice Address - Phone:212-724-8855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009610152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist