Provider Demographics
NPI:1174974190
Name:YEE, DEXTER HANZ ANG (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MR
First Name:DEXTER HANZ
Middle Name:ANG
Last Name:YEE
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 BEACH 68TH ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11692-1316
Mailing Address - Country:US
Mailing Address - Phone:201-600-7682
Mailing Address - Fax:
Practice Address - Street 1:544 BEACH 68TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11692-1316
Practice Address - Country:US
Practice Address - Phone:201-600-7682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30307775364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health