Individual
YVU VAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
113 W ESSEX ST STE 202, MAYWOOD, NJ 07607-1023
(201) 845-6363
(201) 603-1993
Mailing address
PO BOX 626, GREAT RIVER, NY 11739-0626
(631) 892-2745
(631) 201-3179
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
25MA12327200
NJ
208200000X
Plastic Surgery Physician
A184635
CA
Other
Enumeration date
04/07/2017
Last updated
10/29/2024
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