MEDICARE: DR. DAVID MATTHEW YAMINS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	116804	NY

General Provider Information

NPI Number	:	1033143243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID MATTHEW YAMINS M.D.

Provider Business Mailing Address
First Line	:	180 SCHENCK AVE
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11021-3823
Country	:	US
Telephone Number	:	516-487-9789
Fax Number	:	516-482-1239

Provider Business Practice Location Address
First Line	:	5025 FORT HAMILTON PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-3325
Country	:	US
Telephone Number	:	718-435-6333
Fax Number	:	516-482-1239

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	07/08/2007

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