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General NPI Number Information
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NPI Number | 1750536033
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Entity Type | Individual
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Provider Name | YANCY L VAN PATTEN D.O.
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Gender | Male
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Dates
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Enumeration Date | 11/30/2008
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Last Update Date | 08/01/2011
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Provider Practice Location Address
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Address Line | ONE THIRD STREET
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City | BORDENTOWN
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State | NJ
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Zip | 08505-1321
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Country | US
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Telephone | 609-298-2005
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Fax | 609-324-8267
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Provider Business Mailing Address
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Address Line | P.O. BOX 8500-2946
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City | PHIALDELPHIA
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State | PA
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Zip | 19178-2946
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Country | US
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Telephone | 609-815-7810
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Fax | 609-815-7814
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MB08874600
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License Number State | NJ
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