Provider Demographics
NPI:1083050355
Name:NDRIN, YAH BEATRCIE
Entity Type:Individual
Prefix:MS
First Name:YAH
Middle Name:BEATRCIE
Last Name:NDRIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CHILLUM RD # APPT201
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-3306
Mailing Address - Country:US
Mailing Address - Phone:240-478-4834
Mailing Address - Fax:
Practice Address - Street 1:500 CHILLUM RD # APPT201
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-3306
Practice Address - Country:US
Practice Address - Phone:240-478-4834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDN-365847-085-263OtherMVA