Healthcare Provider Details

I. General information

NPI: 1023647369
Provider Name (Legal Business Name): SARAH N YU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2020
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 BERGEN BLVD
PALISADES PARK NJ
07650-2322
US

IV. Provider business mailing address

540 BERGEN BLVD
PALISADES PARK NJ
07650-2322
US

V. Phone/Fax

Practice location:
  • Phone: 201-461-3970
  • Fax: 201-242-9061
Mailing address:
  • Phone: 201-461-3970
  • Fax: 201-242-9061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License Number25MA12676900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License Number329388
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: