Provider Demographics
NPI:1932728656
Name:YANG, CHUNG-YU (DPT)
Entity Type:Individual
Prefix:
First Name:CHUNG-YU
Middle Name:
Last Name:YANG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:ZHONG-YU
Other - Middle Name:
Other - Last Name:YANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8631 56TH AVE APT 3A
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4805
Mailing Address - Country:US
Mailing Address - Phone:201-699-2354
Mailing Address - Fax:
Practice Address - Street 1:8631 56TH AVE APT 3A
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4805
Practice Address - Country:US
Practice Address - Phone:201-699-2354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-13
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12500225100000X
NY045760225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist