Healthcare Provider Details

I. General information

NPI: 1770539157
Provider Name (Legal Business Name): YEE MEDICINE & PEDIATRIC ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 ENGLE ST SUITE 3
ENGLEWOOD NJ
07631-2465
US

IV. Provider business mailing address

PO BOX 127
WYCKOFF NJ
07481-0127
US

V. Phone/Fax

Practice location:
  • Phone: 201-569-9005
  • Fax: 201-569-9080
Mailing address:
  • Phone: 201-569-9005
  • Fax: 201-569-9080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMA67346
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMA67346
License Number StateNJ

VIII. Authorized Official

Name: SAU YAN YEE
Title or Position: PRES/MD
Credential: M.D.
Phone: 201-569-9005