Provider Demographics
NPI:1841427168
Name:YAMAMOTO, MIYA P (MD)
Entity Type:Individual
Prefix:
First Name:MIYA
Middle Name:P
Last Name:YAMAMOTO
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Gender:F
Credentials:MD
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Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX 668
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-487-3420
Mailing Address - Fax:585-334-1264
Practice Address - Street 1:500 RED CREEK DR
Practice Address - Street 2:SUITE 110
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-4284
Practice Address - Country:US
Practice Address - Phone:585-487-3420
Practice Address - Fax:585-334-1264
Is Sole Proprietor?:No
Enumeration Date:2009-06-12
Last Update Date:2021-12-20
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Provider Licenses
StateLicense IDTaxonomies
CAA106814207V00000X
NY261629207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology