Provider Demographics
NPI:1891935524
Name:YE, LIYA (PA)
Entity Type:Individual
Prefix:
First Name:LIYA
Middle Name:
Last Name:YE
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:750 BRUNSWICK AVENUE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08638
Mailing Address - Country:US
Mailing Address - Phone:609-394-6000
Mailing Address - Fax:
Practice Address - Street 1:1117 ROUTE 46 EAST
Practice Address - Street 2:SUITE 206
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013
Practice Address - Country:US
Practice Address - Phone:973-777-5444
Practice Address - Fax:973-777-0304
Is Sole Proprietor?:No
Enumeration Date:2009-02-20
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00204400363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical