Basic Information
Provider Information
NPI: 1689848186
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARAG
FirstName: YOAV
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 175 E 96TH ST
Address2: APARTMENT 14K
City: NEW YORK
State: NY
PostalCode: 101286200
CountryCode: US
TelephoneNumber: 9176777801
FaxNumber:  
Practice Location
Address1: 1 GUSTAVE L LEVY PL
Address2: BOX 1234
City: NEW YORK
State: NY
PostalCode: 100296500
CountryCode: US
TelephoneNumber: 2122411497
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/15/2008
LastUpdateDate: 02/01/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085N0700X252056NYY Allopathic & Osteopathic PhysiciansRadiologyNeuroradiology

No ID Information.


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