Provider Demographics
NPI:1740226448
Name:YAMASHITA, DAWN A (DPM)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:A
Last Name:YAMASHITA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 FULTON ST
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5214
Mailing Address - Country:US
Mailing Address - Phone:718-797-3668
Mailing Address - Fax:718-802-7120
Practice Address - Street 1:420 FULTON ST
Practice Address - Street 2:6TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5214
Practice Address - Country:US
Practice Address - Phone:718-797-3668
Practice Address - Fax:718-802-7120
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005725213E00000X, 213EP1101X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2330789Medicaid
NY2330789Medicaid
NYPG9131Medicare ID - Type Unspecified