MEDICARE: YAMINI ALLA MD

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	207R00000X	Internal Medicine Physician	069692	CT
2	207R00000X	Internal Medicine Physician	1016362	MA
3	207R00000X	Internal Medicine Physician	313589	NY

General Provider Information

NPI Number	:	1689152738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAMINI ALLA MD

Provider Business Mailing Address
First Line	:	1290 SILAS DEANE HWY
Second Line	:
City	:	WETHERSFIELD
State	:	CT
Zip	:	06109-4337
Country	:	US
Telephone Number	:	860-972-9093
Fax Number	:

Provider Business Practice Location Address
First Line	:	4170 ASHFORD DUNWOODY RD NE
Second Line	:
City	:	BROOKHAVEN
State	:	GA
Zip	:	30319-1442
Country	:	US
Telephone Number	:	404-994-3010
Fax Number	:

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

Provider Enumeration Date	:	07/31/2018
Last Update Date	:	04/25/2024

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Directions to “ YAMINI ALLA MD” Practice Location

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