Basic Information
Provider Information
NPI: 1417567751
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BAYKARA
FirstName: YIGIT
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 593 EDDY ST
Address2:  
City: PROVIDENCE
State: RI
PostalCode: 029034923
CountryCode: US
TelephoneNumber: 4014445057
FaxNumber: 4016061233
Practice Location
Address1: 593 EDDY ST
Address2:  
City: PROVIDENCE
State: RI
PostalCode: 029034923
CountryCode: US
TelephoneNumber: 4014445057
FaxNumber: 4016061233
Other Information
ProviderEnumerationDate: 08/02/2020
LastUpdateDate: 08/02/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/02/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102XLP04979RIY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

No ID Information.


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