Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 25MA09095000 | NJ |
NPI | 1003043100 |
---|---|
Provider Name | Dr. Jesson St Yeh |
First Address | Teaneck, NJ 07666-4245 |
Second Address | Teaneck, NJ 07666-4245 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2009 |
Last Update Date | 31/03/2017 |