Provider Demographics
NPI:1801842448
Name:YARMOHAMMADI, HALE (MD)
Entity Type:Individual
Prefix:DR
First Name:HALE
Middle Name:
Last Name:YARMOHAMMADI
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 1:660 WHITE PLAINS RD FL 4
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5139
Mailing Address - Country:US
Mailing Address - Phone:914-984-2546
Mailing Address - Fax:
Practice Address - Street 1:150 BROADWAY RM 1015
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4393
Practice Address - Country:US
Practice Address - Phone:212-571-0355
Practice Address - Fax:212-571-1672
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255690207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI20350Medicare UPIN
NY5N8151Medicare ID - Type Unspecified