Individual
DR. AMIR YAZDANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
470 SEAVIEW AVENUE, STATEN ISLAND, NY 10305-3034
(718) 987-5940
(718) 667-9708
Mailing address
97 NEW DORP LN, SUITE A, STATEN ISLAND, NY 10306-2359
(718) 876-6220
(718) 876-5969
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
158890
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01072971
—
NY
05
—
102286993 0001
—
PA
01
—
A400151565
MEDICARE PTAN
NY
Enumeration date
10/06/2005
Last updated
03/07/2023
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