Provider Demographics
NPI:1730166414
Name:YANG, JUN (M D)
Entity type:Individual
Prefix:DR
First Name:JUN
Middle Name:
Last Name:YANG
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 NORTH GILBERT STREET
Mailing Address - Street 2:SUITE 1201 BLDG #1 SECOND FLOOR
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701
Mailing Address - Country:US
Mailing Address - Phone:732-747-8188
Mailing Address - Fax:732-747-5946
Practice Address - Street 1:55 NORTH GILBERT STREET
Practice Address - Street 2:SUITE 1201 BLDG #1 SECOND FLOOR
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07701-4960
Practice Address - Country:US
Practice Address - Phone:732-747-8188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA078974207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ306397OtherAMERIGROUP
NJ60024315OtherHORIZON NJ HEALTH
NJP2907113OtherOXFORD
NJ8828709Medicaid
NJ01004850000OtherAMERICHOICE
NJ2720467000OtherAMERIHEALTH
NJ36975OtherUNIVERSITY HREALTH PLAN
NJ7868403OtherAETNA
NJ0112365OtherGHI
NJ3K9477OtherHEALTHNET
NJ5678954OtherCIGNA
NJ2326435OtherUNITED HEALTHCARE
NJ3K9477OtherHEALTHNET
NJ36975OtherUNIVERSITY HREALTH PLAN