Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 26NJ00558500 | NJ |
NPI | 1023405842 |
---|---|
Provider Name | Yuliya Bilan Yu |
First Address | Lakewood, NJ 08701-3324 |
Second Address | Lakewood, NJ 08701-3324 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2015 |
Last Update Date | 20/04/2015 |