MEDICARE: MRS. YULIYA NUDELMAN M.D.

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	207R00000X	Internal Medicine Physician	25MA08673400	NJ

General Provider Information

NPI Number	:	1972700037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. YULIYA NUDELMAN M.D.

Provider Business Mailing Address
First Line	:	500 RIVER AVE STE 110
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-4738
Country	:	US
Telephone Number	:	732-339-7360
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 RIVER AVE STE 110
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-4738
Country	:	US
Telephone Number	:	732-339-7360
Fax Number	:

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

Provider Enumeration Date	:	06/29/2007
Last Update Date	:	10/03/2025

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