Healthcare Provider Details

I. General information

NPI: 1194076851
Provider Name (Legal Business Name): PAUL E. YARDEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2012
Last Update Date: 11/23/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E 77TH ST APT 17B
NEW YORK NY
10075-2085
US

IV. Provider business mailing address

201 E 77TH ST APT 17B
NEW YORK NY
10075-2085
US

V. Phone/Fax

Practice location:
  • Phone: 212-628-5001
  • Fax:
Mailing address:
  • Phone: 212-628-5001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number110095
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number110095
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: