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General NPI Number Information
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NPI Number | 1821878067
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Entity Type | Organization
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Legal Business Name | YOUNG SPINE NEUROSURGERY PC
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Dates
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Enumeration Date | 10/04/2023
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Last Update Date | 10/04/2023
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Provider Practice Location Address
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Address Line | 695 RIVERVALE RD
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City | RIVER VALE
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State | NJ
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Zip | 07675-6449
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Country | US
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Telephone | 201-787-7294
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Fax |
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Provider Business Mailing Address
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Address Line | 695 RIVERVALE RD
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City | RIVER VALE
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State | NJ
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Zip | 07675-6449
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Country | US
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Telephone | 201-787-7294
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAY YOUNG CHUN
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Credential | MD
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Telephone | 201-787-7294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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