Provider Demographics
NPI:1952358145
Name:CAMERON, YOTEEN M (MD)
Entity Type:Individual
Prefix:
First Name:YOTEEN
Middle Name:M
Last Name:CAMERON
Suffix:
Gender:F
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 548
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-0548
Mailing Address - Country:US
Mailing Address - Phone:716-773-6906
Mailing Address - Fax:716-773-6868
Practice Address - Street 1:3112 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1904
Practice Address - Country:US
Practice Address - Phone:716-773-6906
Practice Address - Fax:716-773-6868
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY154964207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00808342Medicaid
NYE40181Medicare UPIN
NY00808342Medicaid