Provider Demographics
NPI:1548690746
Name:YEE, PEDRO (LMT)
Entity type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:
Last Name:YEE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 UNION AVE
Mailing Address - Street 2:1 FL
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2628
Mailing Address - Country:US
Mailing Address - Phone:973-772-8988
Mailing Address - Fax:
Practice Address - Street 1:68 UNION AVE
Practice Address - Street 2:1 FL
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2628
Practice Address - Country:US
Practice Address - Phone:973-772-8988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-25
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00028200225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist