Provider Demographics
NPI:1982662334
Name:TOMER, YARON (MD)
Entity Type:Individual
Prefix:DR
First Name:YARON
Middle Name:
Last Name:TOMER
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:PO BOX 1055
Mailing Address - Street 2:ONE GUSTAVE L. LEVY PLACE, MOUNT SINAI MEDICAL CENTER
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-0310
Mailing Address - Country:US
Mailing Address - Phone:212-241-5171
Mailing Address - Fax:212-241-4218
Practice Address - Street 1:5 E 98TH STREET
Practice Address - Street 2:11TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-241-5171
Practice Address - Fax:212-241-4218
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-086786207R00000X, 207RE0101X
NY196150-1207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01801569Medicaid
OH2595893Medicaid
IN200518220Medicaid
KY64108749Medicaid
OH2595893Medicaid
KY64108749Medicaid