Healthcare Provider Details

I. General information

NPI: 1134532005
Provider Name (Legal Business Name): MARK YAZID M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2014
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 NEWMAN SPRINGS RD STE 200
RED BANK NJ
07701-5691
US

IV. Provider business mailing address

200 SCHULZ DR
RED BANK NJ
07701-6776
US

V. Phone/Fax

Practice location:
  • Phone: 732-426-3420
  • Fax:
Mailing address:
  • Phone: 732-426-3420
  • Fax: 848-800-4801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number25MA11799100
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number25MA11799100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: