Healthcare Provider Details
I. General information
NPI: 1407143043
Provider Name (Legal Business Name): ALMA YUM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/04/2011
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
99 BEAUVOIR AVE FL 5
SUMMIT NJ
07901-3533
US
IV. Provider business mailing address
PO BOX 416457
BOSTON MA
02241-6457
US
V. Phone/Fax
- Phone: 908-522-2829
- Fax: 908-522-6147
- Phone: 844-362-1735
- Fax: 973-290-7495
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | 25MA11716700 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0600X |
| Taxonomy | Clinical Neurophysiology Physician |
| License Number | 25MA11716700 |
| License Number State | NJ |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084E0001X |
| Taxonomy | Epilepsy Physician |
| License Number | 25MA11716700 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: