Provider Demographics
NPI:1770539157
Name:YEE MEDICINE & PEDIATRIC ASSOCIATES, PC
Entity type:Organization
Organization Name:YEE MEDICINE & PEDIATRIC ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/MD
Authorized Official - Prefix:
Authorized Official - First Name:SAU YAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-569-9005
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-0127
Mailing Address - Country:US
Mailing Address - Phone:201-569-9005
Mailing Address - Fax:201-569-9080
Practice Address - Street 1:245 ENGLE ST
Practice Address - Street 2:SUITE 3
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2465
Practice Address - Country:US
Practice Address - Phone:201-569-9005
Practice Address - Fax:201-569-9080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA67346208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG39648Medicare UPIN
NJ017841UZ7Medicare ID - Type Unspecified