Provider Demographics
NPI:1669497459
Name:YAGODA, ARNOLD D (MD)
Entity Type:Individual
Prefix:
First Name:ARNOLD
Middle Name:D
Last Name:YAGODA
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 1:67 E 78TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0204
Mailing Address - Country:US
Mailing Address - Phone:212-744-2513
Mailing Address - Fax:212-744-4816
Practice Address - Street 1:67 E 78TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-0204
Practice Address - Country:US
Practice Address - Phone:212-744-2513
Practice Address - Fax:212-744-4816
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY127455-1207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10A001Medicare PIN
NYA99629Medicare UPIN