Most Relevant Information
Provider Data
| NPI Number: | 1003402959 |
| Provider Name: | HAE YOUNG AN |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 566640 |
Most Important Dates
| Enumeration Date: | 12/15/2020 |
| Last Updated: | 12/15/2020 |
Provider Practice Location
1455 BROADWAY
ASTORIA
NY
111064545
Practice Location Phone/Fax
| Phone: | 3472065417 |
| Fax: |
Provider Mailing Location
1455 BROADWAY
ASTORIA
NY
111064545
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |