Provider Demographics
NPI:1801832928
Name:YAHYAZADE, ISMAIL (MD)
Entity Type:Individual
Prefix:DR
First Name:ISMAIL
Middle Name:
Last Name:YAHYAZADE
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 1:3 BRIARS CORNERS
Mailing Address - Street 2:
Mailing Address - City:BRIAR CLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510
Mailing Address - Country:US
Mailing Address - Phone:914-432-5590
Mailing Address - Fax:914-762-2249
Practice Address - Street 1:ROUTE 12 BLDG 449
Practice Address - Street 2:NAVAL AMBULATORY CARE CENTER ATTN PROFESSIONAL AFFAIRS
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06349-5600
Practice Address - Country:US
Practice Address - Phone:860-694-2377
Practice Address - Fax:860-694-2590
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA449582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry