Provider Demographics
NPI:1487722104
Name:YEUNG, VINCENT (MD)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:
Last Name:YEUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 ESSEX ST
Mailing Address - Street 2:GROUND FL.
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-4634
Mailing Address - Country:US
Mailing Address - Phone:347-532-2888
Mailing Address - Fax:718-321-8620
Practice Address - Street 1:40-20 MAIN ST
Practice Address - Street 2:4TH FL
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354
Practice Address - Country:US
Practice Address - Phone:347-532-2888
Practice Address - Fax:718-321-8620
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1942202085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBY5886429Medicaid
NYBY5886429Medicaid
NYG83951Medicare UPIN