Provider Demographics
NPI:1386638963
Name:YAZMAJIAN, DINA R (MD)
Entity Type:Individual
Prefix:DR
First Name:DINA
Middle Name:R
Last Name:YAZMAJIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 WELSH RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-2242
Mailing Address - Country:US
Mailing Address - Phone:215-517-1000
Mailing Address - Fax:215-517-1049
Practice Address - Street 1:118 WELSH RD UNIT B
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-2242
Practice Address - Country:US
Practice Address - Phone:215-517-1000
Practice Address - Fax:215-517-1049
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044824L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAYA883778Medicare ID - Type Unspecified
PAG32401Medicare UPIN