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Organization
TRISTATE WELLNESS & MEDICAL CARE PA
Active
Organization
TRISTATE WELLNESS & MEDICAL CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMI YASIN MD (PRESIDENT)
(973) 875-7121
Entity
Organization
Contact information
Practice address
199 ROUTE 284, WANTAGE, NJ 07461-3417
(973) 875-7121
(973) 875-7123
Mailing address
199 ROUTE 284, WANTAGE, NJ 07461-3417
(973) 875-7121
(973) 875-7123
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
197792-1
NY
207R00000X
Internal Medicine Physician
Primary
25MA05330800
NJ
207R00000X
Internal Medicine Physician
4301087529
MI
207RI0200X
Infectious Disease Physician
197792-1
NY
207RI0200X
Infectious Disease Physician
25MA05330800
NJ
207RI0200X
Infectious Disease Physician
4301087529
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01496762
—
NY
05
—
1054395
—
NJ
05
—
342010801
—
NJ
Enumeration date
10/18/2013
Last updated
10/18/2013
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