Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | MD448653 | PA |
NPI | 1013118231 |
---|---|
Provider Name | Tareq Yasin |
First Address | Carlisle, PA 17015-6953 |
Second Address | Carlisle, PA 17015-6953 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2007 |
Last Update Date | 29/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1028376600001 | (05) | PA |