Provider Demographics
NPI:1366604704
Name:GARGER, YANA BASIS (MD)
Entity type:Individual
Prefix:DR
First Name:YANA
Middle Name:BASIS
Last Name:GARGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SYCAMORE AVE
Mailing Address - Street 2:STE 1
Mailing Address - City:HO HO KUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07423-1588
Mailing Address - Country:US
Mailing Address - Phone:201-474-5952
Mailing Address - Fax:
Practice Address - Street 1:10 SYCAMORE AVE
Practice Address - Street 2:STE 1
Practice Address - City:HO HO KUS
Practice Address - State:NJ
Practice Address - Zip Code:07423-1588
Practice Address - Country:US
Practice Address - Phone:201-474-5952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09273200207RE0101X
NY250075207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY250075OtherLICENSE