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Contact Information

GARY YAM
101 NICOLLS RD
STONY BROOK, NY11794
 Phone: 631-942-4613
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Anesthetist, Certified Registered

367500000X 43 Certified Registered Nurse Anesthetist (CRNA)
 

Acute Care

363LA2100X 50 Nurse Practitioner
 

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for GARY YAM · (Male)

NPI Number 1619485281
Status Active
Credentials
Entity Individual
Enumeration date 01/17/2018
Last updated 11/22/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • NY License # 652027
  • NY License # 652027-01
  • NY License # F431347-01
  • NY Other 652027 NYSED NEW YORK STATE EDUCATION DEPARTMENT
Hospital affiliation(s)
  • SOUTHSIDE HOSPITAL - (Acute Care)
    301 EAST MAIN STREET
    BAY SHORE, NY 11706
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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