Provider Demographics
NPI:1821088295
Name:YODFAT, URIEL A (MD)
Entity type:Individual
Prefix:
First Name:URIEL
Middle Name:A
Last Name:YODFAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:URIEL
Other - Middle Name:AARON
Other - Last Name:YODFAT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 947407
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30394-7407
Mailing Address - Country:US
Mailing Address - Phone:941-917-2600
Mailing Address - Fax:941-917-7884
Practice Address - Street 1:2500 BERNVILLE RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-9453
Practice Address - Country:US
Practice Address - Phone:610-378-2055
Practice Address - Fax:610-378-2058
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME157134207L00000X
PAMD054657L207L00000X
GA102002207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL115086300Medicaid