National Provider Identifier

Edison Jyang, M.D.

Edison Jyang, M.D. is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Ithaca, NY and a listed phone number of (607) 252-3457.

NPI 1154175792Ithaca, NYStudent in an Organized Health Care Education/Training Program

Profile Overview

NPI
1154175792
Provider Type
Individual
Primary Specialty
Student in an Organized Health Care Education/Training Program
Enumeration Date
April 11, 2024
Last Updated
November 22, 2024

Practice Location

  • 101 Dates Drive Cayuga Medical Center
  • Ithaca, NY 14850

Phone: (607) 252-3457

Mailing Address

  • 101 Dates Drive Internal Medicine Residency Cayuga Medi
  • Ithaca, NY 14850

Specialties

  • Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
NPI
1154175792
Entity Type
Individual
Last Name
Jyang
First Name
Edison
Credential
M.D.
Provider Other Last Name
Jyang
Provider Other First Name
Ping-Fong
Provider Other Last Name Type Code
1
Mailing Street Address
101 Dates Drive Internal Medicine Residency Cayuga Medi
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14850
Mailing Country
US
Practice Street Address
101 Dates Drive Cayuga Medical Center
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850
Practice Country
US
Practice Phone
(607) 252-3457
Enumeration Date
April 11, 2024
Last Updated
November 22, 2024
Deactivation Date
November 22, 2024
Reactivation Date
November 22, 2024
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Student in an Organized Health Care Education/Training Program (390200000X)