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General NPI Number Information
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NPI Number | 1467145342
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Entity Type | Organization
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Legal Business Name | NORTHERN MEDICAL SERVICES, PLLC
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Dates
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Enumeration Date | 05/29/2023
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Last Update Date | 03/14/2024
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Provider Practice Location Address
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Address Line | 130 FORT WASHINGTON AVE
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City | NEW YORK
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State | NY
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Zip | 10032-4724
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Country | US
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Telephone | 630-361-6267
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Fax | 845-625-1735
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Provider Business Mailing Address
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Address Line | 14 JASON PL STE 202
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City | MIDDLETOWN
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State | NY
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Zip | 10940-1909
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Country | US
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Telephone | 973-413-7990
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JINGDUAN YANG
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Credential | MD
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Telephone | 973-413-7990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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