Provider Demographics
NPI:1962882365
Name:IYAMU, OSATO I (MD, MSH, CHES)
Entity type:Individual
Prefix:DR
First Name:OSATO
Middle Name:I
Last Name:IYAMU
Suffix:
Gender:F
Credentials:MD, MSH, CHES
Other - Prefix:DR
Other - First Name:OSATOHAMWEN
Other - Middle Name:I
Other - Last Name:IYAMU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, MSH, CHES
Mailing Address - Street 1:20 YORK ST
Mailing Address - Street 2:YALE-NEW HAVEN HOSPITAL
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3220
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20 YORK ST
Practice Address - Street 2:YALE-NEW HAVEN HOSPITAL
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-789-4044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program