MEDICARE: DR. BORIS YAGUDA 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	207L00000X	Anesthesiology Physician	271997	NY

General Provider Information

NPI Number	:	1558672394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BORIS YAGUDA M.D.

Provider Business Mailing Address
First Line	:	1664 E 14TH ST STE 3B
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1155
Country	:	US
Telephone Number	:	347-763-9793
Fax Number	:

Provider Business Practice Location Address
First Line	:	1664 E 14TH ST STE 3B
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1155
Country	:	US
Telephone Number	:	347-763-9793
Fax Number	:

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

Provider Enumeration Date	:	06/26/2010
Last Update Date	:	06/23/2024

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