Provider Demographics
NPI: | 1679588206 |
---|---|
Name: | WU-HSIUNG YANG, MD PC |
Entity type: | Organization |
Organization Name: | WU-HSIUNG YANG, MD PC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | WU-HSIUNG |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | YANG |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 315-462-3568 |
Mailing Address - Street 1: | 97 OLD STONEFIELD WAY |
Mailing Address - Street 2: | |
Mailing Address - City: | PITTSFORD |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 14534-9777 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 585-381-5621 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 4 COULTER RD |
Practice Address - Street 2: | |
Practice Address - City: | CLIFTON SPRINGS |
Practice Address - State: | NY |
Practice Address - Zip Code: | 14432-1122 |
Practice Address - Country: | US |
Practice Address - Phone: | 315-462-3568 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-07-30 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | A114832 | 207VG0400X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207VG0400X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology | Group - Single Specialty |