Provider Demographics
NPI:1952344632
Name:GERMAN, YELENA (MD)
Entity type:Individual
Prefix:
First Name:YELENA
Middle Name:
Last Name:GERMAN
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 1:805 COOPER RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043
Mailing Address - Country:US
Mailing Address - Phone:856-489-3200
Mailing Address - Fax:856-489-3254
Practice Address - Street 1:805 COOPER RD
Practice Address - Street 2:SUITE 1
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043
Practice Address - Country:US
Practice Address - Phone:856-489-3200
Practice Address - Fax:856-489-3254
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA51630207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0790303Medicaid
E53621Medicare UPIN
595774Medicare ID - Type Unspecified