Provider Demographics
NPI:1528421385
Name:YAMMINE, MAROUN BARBAR (MD)
Entity type:Individual
Prefix:
First Name:MAROUN
Middle Name:BARBAR
Last Name:YAMMINE
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 1:101 NICOLLS RD, HEALTH SCIENCES CENTER
Mailing Address - Street 2:LEVEL 19, ROOM 080
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-3845
Mailing Address - Country:US
Mailing Address - Phone:631-444-1820
Mailing Address - Fax:631-444-8963
Practice Address - Street 1:101 NICOLLS RD, HEALTH SCIENCES CENTER,
Practice Address - Street 2:LEVEL 19, RM 080
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8191
Practice Address - Country:US
Practice Address - Phone:631-444-1820
Practice Address - Fax:631-444-8963
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY314512-01208G00000X
NY314512208G00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program