Basic Information
| Provider Information | |||||||||
| NPI: | 1760888366 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SWE | ||||||||
| FirstName: | YUZANA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 HARVEY CIR | ||||||||
| Address2: | |||||||||
| City: | EAST BRUNSWICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088163018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9088090332 | ||||||||
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| Practice Location | |||||||||
| Address1: | 509 N BROAD ST | ||||||||
| Address2: | |||||||||
| City: | WOODBURY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080961617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8568450100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2014 | ||||||||
| LastUpdateDate: | 07/28/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 25MA09898600 | NJ | N | Allopathic & Osteopathic Physicians | Pediatrics | 208M00000X | 25MA09898600 | NJ | N | Allopathic & Osteopathic Physicians | Hospitalist | 207P00000X | 25MA09898600 | NJ | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0517411 | 05 | NJ | MEDICAID |