Basic Information
| Provider Information | |||||||||
| NPI: | 1366182347 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ATEYAT | ||||||||
| FirstName: | YASMINE | ||||||||
| MiddleName: | |||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 REEDS LN | ||||||||
| Address2: | |||||||||
| City: | WEST NEWBURY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019851936 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9788914100 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 463 N WHITE HORSE PIKE | ||||||||
| Address2: | |||||||||
| City: | HAMMONTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080371881 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8009841014 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2022 | ||||||||
| LastUpdateDate: | 03/29/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3336H0001X | 28RI04234900 | NJ | Y | Suppliers | Pharmacy | Home Infusion Therapy Pharmacy | 333600000X | 28RI04234900 | NJ | N | Suppliers | Pharmacy |
No ID Information.