Healthcare Provider Details

I. General information

NPI: 1063716488
Provider Name (Legal Business Name): YONAS T MEHARI DVM, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2010
Last Update Date: 09/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 HOFFMAN BLVD
EAST ORANGE NJ
07017
US

IV. Provider business mailing address

106 HOLLY HILL CT
FRUITLAND MD
21826-1207
US

V. Phone/Fax

Practice location:
  • Phone: 202-276-8882
  • Fax:
Mailing address:
  • Phone: 202-276-8882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number29VI00782900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number6708
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number0301202833
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: