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NPI Code Detail

MEDICARE: DIABETES AND ENDOCRINE CARE PLLC

MEDICARE: DIABETES AND ENDOCRINE CARE PLLC
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
1207RE0101XEndocrinology, Diabetes & Metabolism Physician42177KY

General Provider Information

NPI Number : 1568797488
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIABETES AND ENDOCRINE CARE PLLC
Provider Business Mailing Address
First Line : PO BOX 221317
Second Line :
City : LOUISVILLE
State : KY
Zip : 40252-1317
Country : US
Telephone Number : 502-727-7923
Fax Number : 833-422-0236
Provider Business Practice Location Address
First Line : 1313 SAINT ANTHONY PL
Second Line :
City : LOUISVILLE
State : KY
Zip : 40204-1740
Country : US
Telephone Number : 502-727-7923
Fax Number : 833-422-0236
Authorized Official
Title or Position : OWNER
Name : LINA YASSINE
Credential : M.D.
Telephone Number : 502-727-7923
Provider Enumeration Date : 10/09/2009
Last Update Date : 12/30/2024

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