Basic Information
Provider Information | |||||||||
NPI: | 1730272550 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | YOCOM | ||||||||
FirstName: | STEVEN | ||||||||
MiddleName: | S | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | D.O. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 3 COOPER PLZ | ||||||||
Address2: | SUITE 502 | ||||||||
City: | CAMDEN | ||||||||
State: | NJ | ||||||||
PostalCode: | 081031438 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8569687433 | ||||||||
FaxNumber: | 8569688366 | ||||||||
Practice Location | |||||||||
Address1: | 3 COOPER PLZ | ||||||||
Address2: | SUITE 104 | ||||||||
City: | CAMDEN | ||||||||
State: | NJ | ||||||||
PostalCode: | 081031438 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8563422270 | ||||||||
FaxNumber: | 8569688222 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 10/02/2006 | ||||||||
LastUpdateDate: | 05/08/2015 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | MB07774500 | NJ | Y |   | Allopathic & Osteopathic Physicians | Neurological Surgery |   |
ID Information
ID | Type | State | Issuer | Description | 01000635500 | 01 | NJ | AMERICHOICE | OTHER | 3101760 | 01 | NJ | CIGNA | OTHER | 1635865 | 01 | NJ | AMERIHEALTH PPO/ PA BS | OTHER | 2310995000 | 01 | NJ | AMERIHEALTH/KEYSTONE/IBC | OTHER | 8140804 | 05 | NJ |   | MEDICAID | P3383290 | 01 | NJ | OXFORD | OTHER | 2067170 | 01 | NJ | UNITED HEALTHCARE | OTHER | 60009912 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 3618877 | 01 | NJ | AETNA | OTHER | 1635865 | 01 | NJ | PA BS HIGHMARK | OTHER | 42389 | 01 | NJ | UNIVERSITY HEALTH PLAN | OTHER |