Provider Demographics
NPI:1063511210
Name:YALE, ABRAHAM CHARLES (DPM)
Entity Type:Individual
Prefix:
First Name:ABRAHAM
Middle Name:CHARLES
Last Name:YALE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1881 POST RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-5721
Mailing Address - Country:US
Mailing Address - Phone:203-255-1036
Mailing Address - Fax:203-259-3444
Practice Address - Street 1:1881 POST RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5721
Practice Address - Country:US
Practice Address - Phone:203-255-1036
Practice Address - Fax:203-259-3444
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000283213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT510840OtherAETNA PIN
CT752951OtherUNITED HEALTH PIN
CTZS3200OtherOXFORD PIN
CT030000283CT01OtherANTHEM PIN
CT480000253Medicare ID - Type Unspecified
CT752951OtherUNITED HEALTH PIN