MEDICARE: YOSEF SOLEYMANI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207K00000X	Allergy & Immunology Physician	110791	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	YS08994610	OTHER	NY	BLUE CROSS

General Provider Information

NPI Number	:	1427056613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOSEF SOLEYMANI M.D.

Provider Business Mailing Address
First Line	:	877 STEWART AVE
Second Line	:	SUITE 5
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-4803
Country	:	US
Telephone Number	:	516-794-8772
Fax Number	:

Provider Business Practice Location Address
First Line	:	877 STEWART AVE
Second Line	:	SUITE 5
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-4803
Country	:	US
Telephone Number	:	516-794-8772
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	02/05/2008

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