Provider Demographics
NPI:1912985078
Name:YODICE, PAUL CARMINE (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:CARMINE
Last Name:YODICE
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 1:94 OLD SHORT HILLS RD
Mailing Address - Street 2:SUITE E1-01
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-5672
Mailing Address - Country:US
Mailing Address - Phone:973-322-2782
Mailing Address - Fax:973-322-8564
Practice Address - Street 1:94 OLD SHORT HILLS RD
Practice Address - Street 2:SUITE E1-01
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5672
Practice Address - Country:US
Practice Address - Phone:973-322-2782
Practice Address - Fax:973-322-8564
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-08
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICMD08968207RC0200X
NJ25MA08172700207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine