Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 30.024066 | OH |
N | 1223P0221X | Pediatric Dentist | 058204 | NY |
NPI | 1023432598 |
---|---|
Provider Name | Yassmin Aljaberi |
First Address | New York, NY 10011-3423 |
Second Address | Manhasset, NY 11030-3037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2014 |
Last Update Date | 24/05/2016 |