| Dr. Yan Medical Pllc | |
|
13630 Maple Ave Suite 2-i Flushing NY 11355-3824 | |
| (646) 250-1085 | |
| Not Available |
| Full Name | Dr. Yan Medical Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 13630 Maple Ave, Flushing, New York |
| Authorized Official Name and Position | Xiaorong Yan (OWNER) |
| Authorized Official Contact | 6462501085 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Yan Medical Pllc 13630 Maple Ave Suite 2-i Flushing NY 11335-3865 Ph: () - | Dr. Yan Medical Pllc 13630 Maple Ave Suite 2-i Flushing NY 11355-3824 Ph: (646) 250-1085 |
| NPI Number | 1306365564 |
|---|---|
| Provider Enumeration Date | 09/19/2017 |
| Last Update Date | 10/04/2017 |
| Medicare PECOS PAC ID | 6800152299 |
|---|---|
| Medicare Enrollment ID | O20171120000349 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306365564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 280188 (New York) | Primary |
| Provider Name | Xiaorong Yan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811125776 PECOS PAC ID: 3274685201 Enrollment ID: I20161014002168 |
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