Healthcare Provider Details

I. General information

NPI: 1053409219
Provider Name (Legal Business Name): BAHER S. YANNI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 CRANBURY RD STE 2
EAST BRUNSWICK NJ
08816-3000
US

IV. Provider business mailing address

385 CRANBURY RD STE 2
EAST BRUNSWICK NJ
08816-3000
US

V. Phone/Fax

Practice location:
  • Phone: 609-371-9100
  • Fax: 609-371-9110
Mailing address:
  • Phone: 609-371-9100
  • Fax: 609-371-9109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA08105700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: