Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 25MA08049100 | NJ |
NPI | 1356383566 |
---|---|
Provider Name | Dr. Gary Yen |
First Address | Marlboro, NJ 07746 |
Second Address | Marlboro, NJ 07746-1439 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 08/07/2007 |