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General NPI Number Information
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NPI Number | 1376643817
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Entity Type | Individual
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Provider Name | NEAL STEPHEN YUDKOFF D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 09/24/2006
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Last Update Date | 05/19/2010
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Provider Practice Location Address
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Address Line | 119 GROVE ST
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City | MONTCLAIR
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State | NJ
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Zip | 07042-4044
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Country | US
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Telephone | 973-783-5101
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Fax | 973-783-2821
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Provider Business Mailing Address
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Address Line | 119 GROVE ST
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City | MONTCLAIR
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State | NJ
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Zip | 07042-4044
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Country | US
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Telephone | 973-783-5101
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Fax | 973-783-2821
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | MD01131
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License Number State | NJ
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