Provider Demographics
NPI:1083175897
Name:BARDASH, YONATAN (MD)
Entity Type:Individual
Prefix:
First Name:YONATAN
Middle Name:
Last Name:BARDASH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:YONI
Other - Middle Name:
Other - Last Name:BARDASH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:786 WASHBURN ST
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2243
Mailing Address - Country:US
Mailing Address - Phone:201-575-6710
Mailing Address - Fax:
Practice Address - Street 1:30 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1915
Practice Address - Country:US
Practice Address - Phone:551-996-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA11748400207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology