Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 19699 | MA |
NPI | 1033297049 |
---|---|
Provider Name | Dr. Yean Wu- Young |
First Address | Quincy, MA 02169-4511 |
Second Address | Quincy, MA 02169-4511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1769827 | UNITED CONCORDIA (01) | PA |
X11980 | BLUE CROSS BLUE SHIELD MA (01) | MA |