Provider Demographics
NPI:1467145342
Name:NORTHERN MEDICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:NORTHERN MEDICAL SERVICES, PLLC
Other - Org Name:SY AESTHETICS
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JINGDUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-413-7990
Mailing Address - Street 1:14 JASON PL STE 202
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-1909
Mailing Address - Country:US
Mailing Address - Phone:973-413-7990
Mailing Address - Fax:
Practice Address - Street 1:130 FORT WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-4724
Practice Address - Country:US
Practice Address - Phone:630-361-6267
Practice Address - Fax:845-625-1735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-29
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty