Organization Active NPI

Yuli Fradkin MD LLC

  • Psychiatry Physician
  • Montclair, NJ
National Provider Identifier
1972908960
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA09283000 Issued in NJ
Legal business name
YULI FRADKIN MD LLC
Practice address
94 Valley Rd FL 2
Montclair, NJ 07042-2211
Phone
(646) 685-9836
Fax
(888) 512-2123
NPI assigned
Nov 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Authorized official

Name
Yuli FradkinNPI 1255589461
Title
Provider/Owner
Phone
(646) 685-9836

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 25MA09283000 NJ Primary

Addresses

Primary practice location

94 Valley Rd FL 2
Montclair, NJ 07042-2211

Mailing address

39 James St
Montclair, NJ 07042-2913
Phone (646) 685-9836

Other practice location 1

80 5th Ave Rm 1405
New York, NY 10011-8002
Phone (201) 731-6244

Other practice location 2

440 West St Ste 303
Fort Lee, NJ 07024-5028
Phone (646) 685-9836

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180327000990 NJ Part B Supplier - Clinic/Group Practice 0648596148 Receives reassigned benefits from 3 practitioners
Practice locations: Montclair, NJ
O20260312000245 NY Part B Supplier - Clinic/Group Practice 0648596148 Receives reassigned benefits from 3 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

440 West St
Ste 303
Fort Lee, NJ 07024
Phone (646) 685-9836

1564 Lemoine Ave
Fort Lee, NJ 07024
Phone (201) 794-9797

440 West St
#303
Fort Lee, NJ 07024
Phone (201) 731-6244

94 Valley Rd
#2
Montclair, NJ 07042
Phone (201) 731-6244

80 5th Ave
Rm 1405
New York, NY 10011
Phone (646) 596-6792

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1414972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772582400000",
    "number": "1972908960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 JAMES ST",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422913",
            "telephone_number": "646-685-9836",
            "fax_number": "888-512-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 VALLEY RD FL 2",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422211",
            "telephone_number": "646-685-9836",
            "fax_number": "888-512-2123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 5th Ave Rm 1405",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100118002",
            "country_code": "US",
            "telephone_number": "201-731-6244",
            "fax_number": "888-512-2123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "440 West St Ste 303",
            "address_purpose": "LOCATION",
            "city": "Fort Lee",
            "state": "NJ",
            "postal_code": "070245028",
            "country_code": "US",
            "telephone_number": "646-685-9836",
            "fax_number": "888-512-2123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "YULI FRADKIN MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-03",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A",
        "authorized_official_last_name": "FRADKIN",
        "authorized_official_first_name": "YULI",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "646-685-9836"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA09283000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.