Provider Demographics
NPI:1093038747
Name:YOHAI, JEFFREY A
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:A
Last Name:YOHAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 TERRA MAR DR
Mailing Address - Street 2:
Mailing Address - City:HALESITE
Mailing Address - State:NY
Mailing Address - Zip Code:11743-1449
Mailing Address - Country:US
Mailing Address - Phone:631-427-4640
Mailing Address - Fax:
Practice Address - Street 1:36 MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:COLD SPRING HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11724-1402
Practice Address - Country:US
Practice Address - Phone:631-692-7222
Practice Address - Fax:631-692-7220
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2011-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035013-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist