Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 273077 | MA |
N | 207N00000X | Dermatologist | DR.0058536 | CO |
NPI | 1033559646 |
---|---|
Provider Name | Shelley Yang |
First Address | Acton, MA 01720-3301 |
Second Address | Concord, MA 01742-2137 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2013 |
Last Update Date | 11/11/2021 |