MEDICARE: DR. YASSIN M AUNALI PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PR71780	ME

General Provider Information

NPI Number	:	1295500056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YASSIN M AUNALI PHARMD

Provider Business Mailing Address
First Line	:	184 PEARL ST APT 214
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04101-3099
Country	:	US
Telephone Number	:	360-310-6686
Fax Number	:

Provider Business Practice Location Address
First Line	:	91 AUBURN ST
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-6008
Country	:	US
Telephone Number	:	207-797-4304
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2023
Last Update Date	:	11/21/2023

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