Organization
YANG SHOE CORP. DBA JACOBUS SHOES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YANG SON YANG CPED (SECRETARY)
(201) 567-3333
Entity
Organization
Contact information
Practice address
101 W PALISADE AVE, ENGLEWOOD, NJ 07631-2635
(201) 567-3333
(201) 567-3084
Mailing address
101 W PALISADE AVE, ENGLEWOOD, NJ 07631-2635
(201) 567-3333
(201) 567-3084
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
21096
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0136000
—
NJ
Enumeration date
01/07/2008
Last updated
08/30/2013
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