Healthcare Provider Details

I. General information

NPI: 1538156310
Provider Name (Legal Business Name): THOMAS YU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 02/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 HIGHWAY 37
TOMS RIVER NJ
08755-6423
US

IV. Provider business mailing address

2501 OREGON PIKE SUITE 101
LANCASTER PA
17601-4890
US

V. Phone/Fax

Practice location:
  • Phone: 856-770-3044
  • Fax: 856-770-1515
Mailing address:
  • Phone: 717-293-3223
  • Fax: 717-390-2455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number25MA06168700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: