Healthcare Provider Details

I. General information

NPI: 1174394167
Provider Name (Legal Business Name): YASAMAN HESHMATI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2024
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 ENGLAR RD
WESTMINSTER MD
21157-2929
US

IV. Provider business mailing address

939 BEAVERBANK CIR
TOWSON MD
21286-3315
US

V. Phone/Fax

Practice location:
  • Phone: 410-876-1513
  • Fax:
Mailing address:
  • Phone: 443-912-2233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number29594
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: