Provider Demographics
NPI:1053409219
Name:YANNI, BAHER S (MD)
Entity type:Individual
Prefix:
First Name:BAHER
Middle Name:S
Last Name:YANNI
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 1:300A PRINCETON HIGHTSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-1421
Mailing Address - Country:US
Mailing Address - Phone:609-371-9100
Mailing Address - Fax:609-371-9109
Practice Address - Street 1:300A PRINCETON HIGHTSTOWN RD
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-1421
Practice Address - Country:US
Practice Address - Phone:609-371-9100
Practice Address - Fax:609-371-9109
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08105700207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6756510001OtherDMEPOS PTAN
NJD08938500OtherCDS
NJ6756510001OtherDMEPOS PTAN
NJ117303CDYMedicare PIN
NJD08938500OtherCDS