Provider Demographics
NPI:1811771348
Name:SUN, YONGXIA
Entity type:Individual
Prefix:
First Name:YONGXIA
Middle Name:
Last Name:SUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SILVER STAR CARE
Other - Middle Name:
Other - Last Name:CORP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:14223 37TH AVE APT 2E
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-6528
Mailing Address - Country:US
Mailing Address - Phone:917-528-8908
Mailing Address - Fax:
Practice Address - Street 1:13226 AVERY AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-4954
Practice Address - Country:US
Practice Address - Phone:917-528-8908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care