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General NPI Number Information
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NPI Number | 1609947340
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Entity Type | Individual
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Provider Name | YULIYA BAKSHIYEV MD
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Gender | Female
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 25 KILMER DR STE 217
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City | MORGANVILLE
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State | NJ
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Zip | 07751-1564
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Country | US
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Telephone | 732-617-8888
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Fax | 732-617-8880
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Provider Business Mailing Address
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Address Line | 41 JOSEPH ST
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City | MANALAPAN
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State | NJ
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Zip | 07726-8332
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Country | US
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Telephone | 732-863-1157
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MA64214
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License Number State | NJ
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