Organization
YASSIN PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAHMOUD YASSIN (OWNER)
(609) 971-0010
Entity
Organization
Contact information
Practice address
115 LACEY ROAD, FORKED RIVER, NJ 08731-0537
(609) 971-0010
(609) 242-1906
Mailing address
PO BOX 537, FORKED RIVER, NJ 08731-0537
(609) 971-0010
(609) 242-1906
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MA42926
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3214605
—
NJ
Enumeration date
09/22/2006
Last updated
01/10/2011
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