Healthcare Provider Details

I. General information

NPI: 1477096030
Provider Name (Legal Business Name): NOOR YONO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2016
Last Update Date: 11/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2990 12 MILE RD
BERKLEY MI
48072-1414
US

IV. Provider business mailing address

28890 E KING WILLIAM DR
FARMINGTON HILLS MI
48331-2538
US

V. Phone/Fax

Practice location:
  • Phone: 248-541-0158
  • Fax:
Mailing address:
  • Phone: 248-996-7437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302042330
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: