Provider Demographics
NPI:1447578984
Name:XU, YOUYUAN (MD)
Entity type:Individual
Prefix:
First Name:YOUYUAN
Middle Name:
Last Name:XU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 500
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-0500
Mailing Address - Country:US
Mailing Address - Phone:908-979-1010
Mailing Address - Fax:908-979-9934
Practice Address - Street 1:299 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6166
Practice Address - Country:US
Practice Address - Phone:973-971-5271
Practice Address - Fax:973-290-7370
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-07
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10205400207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04491012Medicaid