Healthcare Provider Details

I. General information

NPI: 1770826034
Provider Name (Legal Business Name): MARY R YAP NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2013
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

477 ROUTE 10 E STE 204
RANDOLPH NJ
07869-2144
US

IV. Provider business mailing address

477 ROUTE 10 E STE 204
RANDOLPH NJ
07869-2144
US

V. Phone/Fax

Practice location:
  • Phone: 973-607-4911
  • Fax: 973-607-4911
Mailing address:
  • Phone: 973-607-4911
  • Fax: 973-607-4911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NO11730100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: