Provider Demographics
NPI:1013021856
Name:MISRA, YASHODHARA (MD)
Entity Type:Individual
Prefix:DR
First Name:YASHODHARA
Middle Name:
Last Name:MISRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 ROUTE 82
Mailing Address - Street 2:SUITE 310
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-7373
Mailing Address - Country:US
Mailing Address - Phone:845-896-8233
Mailing Address - Fax:845-896-3039
Practice Address - Street 1:19 BAKER AVE
Practice Address - Street 2:STE 302
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601
Practice Address - Country:US
Practice Address - Phone:845-483-5888
Practice Address - Fax:845-471-4381
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY141726207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00646117Medicaid
B16861Medicare UPIN
NY00646117Medicaid