Individual
MAHMOUD YASSIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
115 LACEY RD, FORKED RIVER, NJ 08731-4235
(609) 971-0010
Mailing address
115 LACEY RD, FORKED RIVER, NJ 08731-4235
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA04292600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3214605
—
NJ
Enumeration date
08/11/2011
Last updated
08/11/2011
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