Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | MD01131 | NJ |
NPI | 1376643817 |
---|---|
Provider Name | Dr. Neal Stephen Yudkoff |
First Address | Montclair, NJ 07042-4044 |
Second Address | Montclair, NJ 07042-4044 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2006 |
Last Update Date | 19/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T73006 | (02) | NJ |