Provider Demographics
NPI:1346695335
Name:YEUNG, RAPHAEL (DPM)
Entity Type:Individual
Prefix:DR
First Name:RAPHAEL
Middle Name:
Last Name:YEUNG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 ROUTE 28 STE 2109
Mailing Address - Street 2:
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869-1354
Mailing Address - Country:US
Mailing Address - Phone:908-588-2880
Mailing Address - Fax:908-332-5739
Practice Address - Street 1:575 ROUTE 28 STE 2109
Practice Address - Street 2:
Practice Address - City:RARITAN
Practice Address - State:NJ
Practice Address - Zip Code:08869-1354
Practice Address - Country:US
Practice Address - Phone:908-588-2880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-27
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00348900213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist