Healthcare Provider Details

I. General information

NPI: 1316251465
Provider Name (Legal Business Name): JEAN CLAUDE DJELHI YAHOT PHARM. D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2010
Last Update Date: 07/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4530 N 5TH ST
PHILADELPHIA PA
19140-1423
US

IV. Provider business mailing address

4530 N 5TH ST
PHILADELPHIA PA
19140-1423
US

V. Phone/Fax

Practice location:
  • Phone: 215-455-7330
  • Fax: 215-455-2990
Mailing address:
  • Phone: 215-455-7330
  • Fax: 215-455-2990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP441511
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: