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General NPI Number Information
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NPI Number | 1114053071
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Entity Type | Organization
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Legal Business Name | YVAN DUCHEINE MD PC
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 02/24/2011
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Provider Practice Location Address
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Address Line | 150 MAIN ST STE 12
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City | ORANGE
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State | NJ
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Zip | 07050-3700
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Country | US
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Telephone | 973-674-4042
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Fax | 973-674-5070
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Provider Business Mailing Address
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Address Line | 150 MAIN ST STE 12
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City | ORANGE
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State | NJ
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Zip | 07050-3700
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Country | US
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Telephone | 973-674-4042
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Fax | 973-674-5070
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YVAN DUCHEINE
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Credential | MD
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Telephone | 973-674-4042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 25MA06289400
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License Number State | NJ
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