Provider Demographics
NPI:1639344682
Name:YALE-LOEHR, AMY JANET (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:JANET
Last Name:YALE-LOEHR
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 1:301 HIGHGATE RD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1437
Mailing Address - Country:US
Mailing Address - Phone:607-257-4124
Mailing Address - Fax:
Practice Address - Street 1:301 HIGHGATE RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1437
Practice Address - Country:US
Practice Address - Phone:607-257-4124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY181657-12085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01205196Medicaid
NY01205196Medicaid