Provider Demographics
NPI:1780690875
Name:YAN, ALBERT C (MD)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:C
Last Name:YAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 E PENN SQ
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3323
Mailing Address - Country:US
Mailing Address - Phone:267-425-9258
Mailing Address - Fax:267-425-9299
Practice Address - Street 1:3550 MARKET ST FL 2
Practice Address - Street 2:CHILDREN'S HOSPITAL OF PHILADELPHIA - DERMATOLOGY DIV
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3366
Practice Address - Country:US
Practice Address - Phone:215-590-9119
Practice Address - Fax:215-590-4948
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2015-03-05
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Provider Licenses
StateLicense IDTaxonomies
PAMD059207L207N00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001625910Medicaid
NJ7197608Medicaid
NJ7197608Medicaid
PA001625910Medicaid