Provider Demographics
NPI:1144268400
Name:YU, WEIZHEN (PHD)
Entity type:Individual
Prefix:DR
First Name:WEIZHEN
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26246
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-6246
Mailing Address - Country:US
Mailing Address - Phone:718-604-5574
Mailing Address - Fax:718-604-5527
Practice Address - Street 1:156 W 56TH ST STE 1804
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3878
Practice Address - Country:US
Practice Address - Phone:212-851-8100
Practice Address - Fax:212-537-0102
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015141103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02748401Medicaid
NYA400047795Medicare PIN
NY02748401Medicaid
NYP96983Medicare UPIN