Provider Demographics
NPI:1447859491
Name:YAHIA, IMAN NAGI (PHARMD)
Entity type:Individual
Prefix:DR
First Name:IMAN
Middle Name:NAGI
Last Name:YAHIA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 17TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-5374
Mailing Address - Country:US
Mailing Address - Phone:718-374-4524
Mailing Address - Fax:
Practice Address - Street 1:182 17TH ST APT 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-5374
Practice Address - Country:US
Practice Address - Phone:718-374-4524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1063723183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty