Provider Demographics
NPI:1407938053
Name:YAPOR, EDDY NORBERTO
Entity Type:Individual
Prefix:DR
First Name:EDDY
Middle Name:NORBERTO
Last Name:YAPOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:698 HARTWELL ST
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-5311
Mailing Address - Country:US
Mailing Address - Phone:201-837-7629
Mailing Address - Fax:
Practice Address - Street 1:6412 PARK AVE
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-4126
Practice Address - Country:US
Practice Address - Phone:201-868-9007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI022682001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice