=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114433786
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YULIYA TSIMRING DO
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/19/2017
-----------------------------------------------------
Last Update Date | 02/19/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1466 ROUTE 88 STE E
-----------------------------------------------------
City | BRICK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08724-2341
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-784-8840
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1466 ROUTE 88 STE E
-----------------------------------------------------
City | BRICK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08724-2341
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-784-8840
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 25MB10569500
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 204D00000X
-----------------------------------------------------
Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
-----------------------------------------------------
License Number | 25MB10569500
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------