Healthcare Provider Details

I. General information

NPI: 1952377103
Provider Name (Legal Business Name): GIDEON YOELI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 01/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 WESTCHESTER AVE
WHITE PLAINS NY
10604-2901
US

IV. Provider business mailing address

210 WESTCHESTER AVE 3RD FLOOR
WHITE PLAINS NY
10604-2901
US

V. Phone/Fax

Practice location:
  • Phone: 914-682-6430
  • Fax: 914-682-6403
Mailing address:
  • Phone: 914-682-6430
  • Fax: 914-682-6403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number143316
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: