Basic Information
Provider Information
NPI: 1629196506
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VAN BOCHOVE
FirstName: YVONNE
MiddleName: P
NamePrefix: DR.
NameSuffix:  
Credential: PT,DPT,MA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1255 CALDWELL RD
Address2:  
City: CHERRY HILL
State: NJ
PostalCode: 080343220
CountryCode: US
TelephoneNumber: 8563481209
FaxNumber: 8564294755
Practice Location
Address1: 666 PLAINSBORO RD
Address2: 2000 C
City: PLAINSBORO
State: NJ
PostalCode: 085363030
CountryCode: US
TelephoneNumber: 6097998400
FaxNumber: 8564294755
Other Information
ProviderEnumerationDate: 03/27/2007
LastUpdateDate: 08/31/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X40QA00519800NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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