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General NPI Number Information
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NPI Number | 1700894581
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Entity Type | Individual
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Provider Name | AYMAN SAMIR YASSA MD
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Gender | Male
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 07/01/2009
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Provider Practice Location Address
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Address Line | 622 W 168TH ST PH1 - 137
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City | NEW YORK
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State | NY
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Zip | 10032-3720
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Country | US
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Telephone | 212-305-2995
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Fax |
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Provider Business Mailing Address
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Address Line | 622 WEST 168TH STREET PH1 - 137
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City | NEW YORK
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State | NY
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Zip | 10032-0001
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Country | US
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Telephone | 507-305-2995
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 48806
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 252968
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License Number State | NY
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