Healthcare Provider Details

I. General information

NPI: 1609040286
Provider Name (Legal Business Name): YAEL KRYZMAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2008
Last Update Date: 05/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 PANGBORN PL
HACKENSACK NJ
07601-4506
US

IV. Provider business mailing address

135 COUNTY RD STE 2
CRESSKILL NJ
07626-2201
US

V. Phone/Fax

Practice location:
  • Phone: 201-488-8866
  • Fax:
Mailing address:
  • Phone: 201-568-9811
  • Fax: 201-568-5494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI02398000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number054034-1
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: