Provider Demographics
NPI:1881628246
Name:YEE, MARY (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:
Last Name:YEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:444 NEPTUNE BOULEVARD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753
Mailing Address - Country:US
Mailing Address - Phone:732-774-4332
Mailing Address - Fax:732-774-4077
Practice Address - Street 1:444 NEPTUNE BOULEVARD
Practice Address - Street 2:SUITE 4
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753
Practice Address - Country:US
Practice Address - Phone:732-774-4332
Practice Address - Fax:732-774-4077
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05481300208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0934704Medicaid
NJ2626608Medicaid
NJ0934704Medicaid