Provider Demographics
NPI:1558397752
Name:YOSHA, ASSAF (MD)
Entity Type:Individual
Prefix:
First Name:ASSAF
Middle Name:
Last Name:YOSHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX 278980
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-758-0750
Mailing Address - Fax:585-872-0876
Practice Address - Street 1:55 BARRETT DR
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2927
Practice Address - Country:US
Practice Address - Phone:585-758-0750
Practice Address - Fax:585-872-0876
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY230863207Q00000X
WAMD00046307207Q00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03078677Medicaid