Healthcare Provider Details

I. General information

NPI: 1902833536
Provider Name (Legal Business Name): PAULA YEGHIAYAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 09/10/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 E 31ST ST APT 23F
NEW YORK NY
10016-6872
US

IV. Provider business mailing address

300 WESTAGE BUSINESS CTR DR SUITE 280
FISHKILL NY
12524-2260
US

V. Phone/Fax

Practice location:
  • Phone: 212-213-3226
  • Fax:
Mailing address:
  • Phone: 800-835-3723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number231622
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number231622
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: