| Yuli Fradkin Md Llc | |
|
94 Valley Rd Fl 2 Montclair NJ 07042-2211 | |
| (646) 685-9836 | |
| (888) 512-2123 |
| Full Name | Yuli Fradkin Md Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 94 Valley Rd Fl 2, Montclair, New Jersey |
| Authorized Official Name and Position | Yuli Fradkin (OWNER) |
| Authorized Official Contact | 6466859836 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yuli Fradkin Md Llc 39 James St Montclair NJ 07042-2913 Ph: (646) 685-9836 | Yuli Fradkin Md Llc 94 Valley Rd Fl 2 Montclair NJ 07042-2211 Ph: (646) 685-9836 |
| NPI Number | 1972908960 |
|---|---|
| Provider Enumeration Date | 11/03/2014 |
| Last Update Date | 03/25/2023 |
| Certification Date | 03/25/2023 |
| Medicare PECOS PAC ID | 0648596148 |
|---|---|
| Medicare Enrollment ID | O20180327000990 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972908960 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 25MA09283000 (New Jersey) | Primary |
| Provider Name | Yuli Fradkin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255589461 PECOS PAC ID: 5496936924 Enrollment ID: I20140924000085 |
| Provider Name | Natalya Meyerzon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356032122 PECOS PAC ID: 6507224581 Enrollment ID: I20230623000557 |
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