Provider Demographics
NPI:1750482501
Name:YU, YIN TAT (MD)
Entity Type:Individual
Prefix:
First Name:YIN
Middle Name:TAT
Last Name:YU
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 1:462 LAKEHURST RD STE A
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6345
Mailing Address - Country:US
Mailing Address - Phone:732-244-9020
Mailing Address - Fax:732-244-2902
Practice Address - Street 1:462 LAKEHURST RD STE A
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6345
Practice Address - Country:US
Practice Address - Phone:732-244-9020
Practice Address - Fax:732-244-2902
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07844900207L00000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ105760A01Medicare PIN
NJ105760CDZMedicare PIN
NJ105760CDYMedicare PIN