Provider Demographics
NPI:1114053071
Name:YVAN DUCHEINE MD PC
Entity Type:Organization
Organization Name:YVAN DUCHEINE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUCHEINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-674-4042
Mailing Address - Street 1:150 MAIN ST STE 12
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07050-3700
Mailing Address - Country:US
Mailing Address - Phone:973-674-4042
Mailing Address - Fax:973-674-5070
Practice Address - Street 1:150 MAIN ST STE 12
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07050-3700
Practice Address - Country:US
Practice Address - Phone:973-674-4042
Practice Address - Fax:973-674-5070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06289400208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ01077777600OtherAMERICHOICE
NJ549989OtherAETNA US HEALTHCARE
NJ72L61OtherEMPIRE BCBS
NJ1059165OtherHORIZON NJ HEALTH
NJ721611OtherWELLCHOICE
NJJ13132OtherACS HEALTHNET
NJ21188OtherUNIVERSITY HEALTH PLANS
NJ000953156OtherAMERIHEALTH
NJ020041849OtherRAILROAD MEDICARE
NJ0101394OtherGHI
NJ7188005Medicaid
NJP856821OtherOXFORDHEALTH INC.
NJ15603OtherAMERIGROUP
NJ1385908OtherUNITED HEALTHCARE INS.
NJ72L61OtherEMPIRE BCBS
NJ7188005Medicaid
NJ01077777600OtherAMERICHOICE
NJ020041849OtherRAILROAD MEDICARE
NJ1059165OtherHORIZON NJ HEALTH
NJ=========OtherQUALCARE