Al-Lateef Yancey

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

32WD02927600 Issued in NJ

Practice address

508 S Orange Ave
Newark, NJ 07103-1338

Phone

(973) 277-6417

NPI assigned

Sep 21, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1245953603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 S ORANGE AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071031338",
            "telephone_number": "973-277-6417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 S ORANGE AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071031338",
            "telephone_number": "973-277-6417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANCEY",
        "first_name": "AL-LATEEF",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NJ",
            "license": "32WD02927600",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NJ",
            "license": "32WD02927600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Robert Yalkowsky, PH.D.
• Yee-Kuen Yam, MD, PHD
• Yamna LLC
• Vanessa Yamuca, LSW
• Kenneth Yan, M.D., PH.D.
• Ricky Yang
• Jennifer Lynn Yanik
• Rachel Mara Yanosh, MS, LAT, ATC, EMT
• Nibras Yar Khan, MD
• Justin Yarngo

• Prosthetic/Orthotic Supplier in Newark, NJ
• Providers in Newark, NJ by specialty
• Prosthetic/Orthotic Supplier in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.