Provider Demographics
NPI:1710934393
Name:JOSEPH A YUPPA MD PA
Entity Type:Organization
Organization Name:JOSEPH A YUPPA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:YUPPA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-891-9245
Mailing Address - Street 1:690 ORCHARD LANE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-2248
Mailing Address - Country:US
Mailing Address - Phone:201-891-9245
Mailing Address - Fax:201-891-9245
Practice Address - Street 1:690 ORCHARD LANE
Practice Address - Street 2:
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-2248
Practice Address - Country:US
Practice Address - Phone:201-891-9245
Practice Address - Fax:201-891-9245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02048200207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C53062Medicare UPIN
NJYU083825Medicare ID - Type Unspecified