Provider Demographics
NPI:1942402599
Name:YANOW, JENNIFER HANNAH (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:HANNAH
Last Name:YANOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 ROUTE 22 STE 200
Mailing Address - Street 2:
Mailing Address - City:MOUNTAINSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07092-2619
Mailing Address - Country:US
Mailing Address - Phone:917-270-7677
Mailing Address - Fax:
Practice Address - Street 1:1450 ROUTE 22 STE 200
Practice Address - Street 2:
Practice Address - City:MOUNTAINSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07092-2619
Practice Address - Country:US
Practice Address - Phone:917-270-7677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242728208100000X
NJ25MA08607600207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation