Provider Demographics
NPI:1699882910
Name:PATRON, MARIA YOLANDA PIAMONTE (MD)
Entity type:Individual
Prefix:
First Name:MARIA YOLANDA
Middle Name:PIAMONTE
Last Name:PATRON
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 1:7902 ROOSEVELT AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6717
Mailing Address - Country:US
Mailing Address - Phone:718-779-3333
Mailing Address - Fax:718-779-4422
Practice Address - Street 1:7902 ROOSEVELT AVE
Practice Address - Street 2:SUITE B
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6717
Practice Address - Country:US
Practice Address - Phone:718-779-3333
Practice Address - Fax:718-779-4422
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY239269208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02743740Medicaid