Provider Demographics
NPI:1063952729
Name:YUEN, RONNIE C JR
Entity type:Individual
Prefix:MR
First Name:RONNIE
Middle Name:C
Last Name:YUEN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 N WHITE HORSE PIKE
Mailing Address - Street 2:UNIT- D
Mailing Address - City:SOMERDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08083-1547
Mailing Address - Country:US
Mailing Address - Phone:856-882-9488
Mailing Address - Fax:
Practice Address - Street 1:409 N WHITE HORSE PIKE
Practice Address - Street 2:UNIT- D
Practice Address - City:SOMERDALE
Practice Address - State:NJ
Practice Address - Zip Code:08083-1547
Practice Address - Country:US
Practice Address - Phone:856-882-9488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ32WD029182001744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management