Provider Information for 1255979688
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LIZHEN YAN
Sex: Female
NPI: 1255979688
Last Updated: 2019-12-16
Certification Date: 2019-12-16
Certification Date: 2019-12-16
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1255979688 | ||||||||
| Enumeration Date | 2019-12-16 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1115 INMAN AVE STE 369 EDISON, NJ 08820-1132 United States Phone: 848-219-0869 | Fax: | ||||||||
| Primary Practice Address | 12 BERNICE ST EDISON, NJ 08820-1727 United States Phone: 848-219-0869 | Fax: | ||||||||
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