Provider Demographics
NPI:1447210323
Name:YALAMANCHILI, RAO AK (MD)
Entity Type:Individual
Prefix:DR
First Name:RAO
Middle Name:AK
Last Name:YALAMANCHILI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6 ROMER RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-1227
Mailing Address - Country:US
Mailing Address - Phone:718-624-6495
Mailing Address - Fax:718-643-1440
Practice Address - Street 1:159 CLINTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4601
Practice Address - Country:US
Practice Address - Phone:718-624-6495
Practice Address - Fax:718-643-1440
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY116820207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD46808Medicare UPIN