Organization
BERGEN ENDOCRINOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIMA YESHOU (MD)
(201) 281-7835
Entity
Organization
Contact information
Practice address
12-04 SADDLE RIVER RD, FAIR LAWN, NJ 07410-5811
(201) 773-8710
(201) 773-8711
Mailing address
560 CLINTON RD, PARAMUS, NJ 07652
(201) 967-8425
(201) 263-4665
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
25MA08384100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0190861
—
NJ
Enumeration date
09/29/2008
Last updated
10/13/2015
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