Provider Demographics
NPI:1760789515
Name:CIARAMITARO, YESSENIA ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:YESSENIA
Middle Name:ELIZABETH
Last Name:CIARAMITARO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:YESSENIA
Other - Middle Name:ELIZABETH
Other - Last Name:COELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1111 AMSTERDAM AVE
Mailing Address - Street 2:SUITE 5W-140
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-1716
Mailing Address - Country:US
Mailing Address - Phone:718-854-7344
Mailing Address - Fax:212-523-8055
Practice Address - Street 1:1111 AMSTERDAM AVE
Practice Address - Street 2:SUITE 5W-140
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1716
Practice Address - Country:US
Practice Address - Phone:212-523-8050
Practice Address - Fax:212-523-8055
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY260342-1208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY12260502OtherCAQH ID