Provider Demographics
NPI:1104189844
Name:CAVANAGH, YANA
Entity Type:Individual
Prefix:DR
First Name:YANA
Middle Name:
Last Name:CAVANAGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 MAIN ST
Mailing Address - Street 2:ST. JOSEPH'S REGIONAL MEDICAL CENTER, INTERNAL MEDICINE
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503-2621
Mailing Address - Country:US
Mailing Address - Phone:973-754-2431
Mailing Address - Fax:973-754-3376
Practice Address - Street 1:703 MAIN ST
Practice Address - Street 2:ST. JOSEPH'S REGIONAL MEDICAL CENTER, INTERNAL MEDICINE
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-2621
Practice Address - Country:US
Practice Address - Phone:973-754-2431
Practice Address - Fax:973-754-3376
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09717000207RG0100X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program