MEDICARE: LEE H YASGUR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	25MA039265	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225118771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEE H YASGUR MD

Provider Business Mailing Address
First Line	:	19 ROBIN LAKE DRIVE
Second Line	:	CHERRY HILL
City	:	CHERRY HILL
State	:	NJ
Zip	:	08003
Country	:	US
Telephone Number	:	856-429-0997
Fax Number	:	856-429-4799

Provider Business Practice Location Address
First Line	:	1415 RT 70 EAST
Second Line	:	CHERRY HILL
City	:	CHERRY HILL
State	:	NJ
Zip	:	08034-2210
Country	:	US
Telephone Number	:	856-429-0997
Fax Number	:	856-429-4799

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	01/15/2021

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