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General NPI Number Information
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NPI Number | 1346258381
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Entity Type | Organization
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Legal Business Name | MICHAEL YOONG MDPA
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 12/14/2007
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Provider Practice Location Address
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Address Line | 2630 E CHESTNUT AVENUE
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City | VINELAND
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State | NJ
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Zip | 08361
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Country | US
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Telephone | 856-691-1658
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Fax | 856-692-1558
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Provider Business Mailing Address
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Address Line | 2630 E CHESTNUT AVE
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City | VINELAND
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State | NJ
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Zip | 08361
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Country | US
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Telephone | 856-691-1658
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Fax | 856-692-1558
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | DR. MICHAEL YOONG
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Credential | MDPA
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Telephone | 856-691-1658
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | MA35922
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License Number State | NJ
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