Healthcare Provider Details

I. General information

NPI: 1831249176
Provider Name (Legal Business Name): YITZCHAK ARIEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 10/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901-48 STREET
BROOKLYN NY
11219-2919
US

IV. Provider business mailing address

1710 AVENUE I
BROOKLYN NY
11230-3110
US

V. Phone/Fax

Practice location:
  • Phone: 718-436-3705
  • Fax: 718-435-6188
Mailing address:
  • Phone: 718-436-3705
  • Fax: 718-435-6188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number208486
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: