Healthcare Provider Details

I. General information

NPI: 1598992745
Provider Name (Legal Business Name): AMMAR NOORUDDIN YAMANI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2009
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 CEDAR STREET TMP 3
NEW HAVEN CT
06520
US

IV. Provider business mailing address

669 PARADISE AVE
HAMDEN CT
06514-1506
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-2802
  • Fax:
Mailing address:
  • Phone: 832-687-7863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number051936
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberQ8812
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number051936
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: