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NPI Code Detail

MEDICARE: DR. YASMIN J GHADIALI DDS

MEDICARE: DR. YASMIN J GHADIALI DDS
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
1122300000XDentist034128-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124001136
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. YASMIN J GHADIALI DDS
Provider Business Mailing Address
First Line : 2686 BELCHER ST
Second Line :
City : BALDWIN
State : NY
Zip : 11510-3937
Country : US
Telephone Number : 718-467-3098
Fax Number :
Provider Business Practice Location Address
First Line : 314 RALPH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11233-3022
Country : US
Telephone Number : 718-467-3098
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2005
Last Update Date : 07/08/2007

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