Healthcare Provider Details

I. General information

NPI: 1801976824
Provider Name (Legal Business Name): EDWARD E. YOST M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 01/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 OLD COUNTRY RD
PLAINVIEW NY
11803-4942
US

IV. Provider business mailing address

761 MIDDLE COUNTRY RD
SELDEN NY
11784-2550
US

V. Phone/Fax

Practice location:
  • Phone: 516-681-0202
  • Fax:
Mailing address:
  • Phone: 631-736-4064
  • Fax: 631-736-1332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number219729
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier02621492
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer
# 2
Identifier25MA08471800
Identifier TypeOTHER
Identifier StateNJ
Identifier IssuerNJ LICENSE
# 3
IdentifierMD431920
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerPENNSYLVANIA LICENSE
# 4
Identifier219729
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerNEW YORK LICENSE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: