=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497548499
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | YVHH LIMITED LIABILITY COMPANY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/23/2025
-----------------------------------------------------
Last Update Date | 05/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 402 FOREST AVE
-----------------------------------------------------
City | LYNDHURST
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07071-2411
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-699-2008
-----------------------------------------------------
Fax | 973-322-8072
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 402 FOREST AVE
-----------------------------------------------------
City | LYNDHURST
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07071-2411
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-699-2008
-----------------------------------------------------
Fax | 973-322-8072
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | YOSLEISY HERNANDEZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 201-699-2008
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------