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General NPI Number Information
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NPI Number | 1306115738
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Entity Type | Individual
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Provider Name | AHMED MOH'D ABDEL LATIF YASSIN
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Gender | Male
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Dates
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Enumeration Date | 12/13/2011
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Last Update Date | 09/08/2015
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Provider Practice Location Address
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Address Line | 3471 5TH AVE SUITE 811
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City | PITTSBURGH
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State | PA
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Zip | 15213-3215
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Country | US
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Telephone | 412-624-1277
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Fax | 412-624-2302
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Provider Business Mailing Address
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Address Line | 3471 5TH AVE SUITE 811
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City | PITTSBURGH
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State | PA
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Zip | 15213-3215
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Country | US
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Telephone | 412-624-1277
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Fax | 412-624-2302
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 210004
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License Number State | PA
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