Basic Information
Provider Information
NPI: 1073797353
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YAAR
FirstName: RON
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D., PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 706 GREEN VALLEY RD
Address2: SUITE 104
City: GREENSBORO
State: NC
PostalCode: 274087038
CountryCode: US
TelephoneNumber: 3362714930
FaxNumber: 3362718466
Practice Location
Address1: 61 MONROE AVE STE B
Address2:  
City: PITTSFORD
State: NY
PostalCode: 145341311
CountryCode: US
TelephoneNumber: 5855865166
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/22/2007
LastUpdateDate: 01/21/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0101X234767MAN Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
207ZD0900X234767MAY Allopathic & Osteopathic PhysiciansPathologyDermatopathology

No ID Information.


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