Provider Demographics
NPI:1932413143
Name:YUEN, ERIC (DPT, RHIA)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:YUEN
Suffix:
Gender:M
Credentials:DPT, RHIA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 W HUNTING PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-2717
Mailing Address - Country:US
Mailing Address - Phone:215-455-5370
Mailing Address - Fax:215-455-5374
Practice Address - Street 1:133 W HUNTING PARK AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-2717
Practice Address - Country:US
Practice Address - Phone:215-455-5370
Practice Address - Fax:215-455-5374
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT020696225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA194723OtherMEDICARE ID
PA1028629300001Medicaid