Provider Demographics
NPI:1013151257
Name:SCOTT YAGER MD LLC
Entity Type:Organization
Organization Name:SCOTT YAGER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:YAGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-432-7040
Mailing Address - Street 1:4 CORNWALL DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3332
Mailing Address - Country:US
Mailing Address - Phone:732-432-7040
Mailing Address - Fax:732-432-7183
Practice Address - Street 1:4 CORNWALL DR
Practice Address - Street 2:SUITE 201
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3332
Practice Address - Country:US
Practice Address - Phone:732-432-7040
Practice Address - Fax:732-432-7183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06085600261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF82708Medicare UPIN