MEDICARE: DR. ANNA H. YELLOZ 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	208000000X	Pediatrics Physician	258524	NY

General Provider Information

NPI Number	:	1750575759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNA H. YELLOZ M.D.

Provider Business Mailing Address
First Line	:	1425 54TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-4228
Country	:	US
Telephone Number	:	718-438-0666
Fax Number	:	718-437-6385

Provider Business Practice Location Address
First Line	:	1425 54TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-4228
Country	:	US
Telephone Number	:	718-438-0666
Fax Number	:	718-437-6385

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

Provider Enumeration Date	:	09/01/2007
Last Update Date	:	05/07/2012

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