MEDICARE: DR. RAO A.K. YALAMANCHILI 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	207KA0200X	Allergy Physician	116820	NY

General Provider Information

NPI Number	:	1447210323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAO A.K. YALAMANCHILI M.D.

Provider Business Mailing Address
First Line	:	6 ROMER RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-1227
Country	:	US
Telephone Number	:	718-624-6495
Fax Number	:	718-643-1440

Provider Business Practice Location Address
First Line	:	159 CLINTON ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-4601
Country	:	US
Telephone Number	:	718-624-6495
Fax Number	:	718-643-1440

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

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	07/09/2007

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