Healthcare Provider Details

I. General information

NPI: 1487762050
Provider Name (Legal Business Name): SANDY YEUM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 07/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 E NORTHFIELD RD
LIVINGSTON NJ
07039-4532
US

IV. Provider business mailing address

42 LORRAINE RD
MADISON NJ
07940-1325
US

V. Phone/Fax

Practice location:
  • Phone: 973-436-1410
  • Fax: 973-379-4724
Mailing address:
  • Phone: 973-325-5670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMA727222
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: