MEDICARE: DR. DONNA MERLE YAFFE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	03471	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6100122	OTHER	MD	EVERCARE
2	60484701	OTHER	MD	BCBS MD

General Provider Information

NPI Number	:	1033158050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONNA MERLE YAFFE

Provider Business Mailing Address
First Line	:	8423 TALLY HO RD
Second Line	:
City	:	LUTHERVILLE
State	:	MD
Zip	:	21093-4725
Country	:	US
Telephone Number	:	703-425-8269
Fax Number	:

Provider Business Practice Location Address
First Line	:	5610A SANDY LEWIS DR
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22032-4034
Country	:	US
Telephone Number	:	800-688-7733
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. DONNA MERLE YAFFE ” Practice Location

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