Provider Demographics
NPI:1710184833
Name:OSBAND, YARDAENA BATYA (MD)
Entity Type:Individual
Prefix:DR
First Name:YARDAENA
Middle Name:BATYA
Last Name:OSBAND
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 1:4350 VAN CORTLANDT PARK E
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10470-1875
Mailing Address - Country:US
Mailing Address - Phone:718-231-6565
Mailing Address - Fax:718-231-8477
Practice Address - Street 1:4350 VAN CORTLANDT PARK E
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10470-1875
Practice Address - Country:US
Practice Address - Phone:718-231-6565
Practice Address - Fax:718-231-8477
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY244517208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02900118Medicaid
NY02900118Medicaid
NY1B196EA201Medicare PIN