MEDICARE: YALAMANCHI K RAO 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	207K00000X	Allergy & Immunology Physician	124582	NY

General Provider Information

NPI Number	:	1437153301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YALAMANCHI K RAO M.D.

Provider Business Mailing Address
First Line	:	565 BAY RIDGE PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-3309
Country	:	US
Telephone Number	:	718-748-7551
Fax Number	:	718-921-9351

Provider Business Practice Location Address
First Line	:	565 BAY RIDGE PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-3309
Country	:	US
Telephone Number	:	718-748-7551
Fax Number	:	718-921-9351

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	07/08/2007

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