=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457295545
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PALA MAYA CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/17/2026
-----------------------------------------------------
Last Update Date | 06/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 160 S LIVINGSTON AVE STE 207
-----------------------------------------------------
City | LIVINGSTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07039-3071
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 862-456-8831
-----------------------------------------------------
Fax | 302-497-8427
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 884 WALNUT PL
-----------------------------------------------------
City | LAKE HOPATCONG
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07849-2464
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-444-6266
-----------------------------------------------------
Fax | 302-497-8427
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PMHNP-BC
-----------------------------------------------------
Name | YANNICK ZEBAZE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 973-444-6266
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------