Provider Demographics
NPI:1164875050
Name:YU, EN
Entity type:Individual
Prefix:
First Name:EN
Middle Name:
Last Name:YU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15015 BARCLAY AVE # S1
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-1099
Mailing Address - Country:US
Mailing Address - Phone:718-301-1999
Mailing Address - Fax:646-863-5426
Practice Address - Street 1:15015 BARCLAY AVE # S1
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-1099
Practice Address - Country:US
Practice Address - Phone:718-301-1999
Practice Address - Fax:646-863-5426
Is Sole Proprietor?:No
Enumeration Date:2016-07-15
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care