Provider Demographics
NPI:1477727980
Name:BOADIH, YVONNE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:YVONNE
Middle Name:
Last Name:BOADIH
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 1:1764 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02905-3519
Mailing Address - Country:US
Mailing Address - Phone:401-461-6438
Mailing Address - Fax:401-461-0989
Practice Address - Street 1:1764 BROAD ST
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02905-3519
Practice Address - Country:US
Practice Address - Phone:401-461-6438
Practice Address - Fax:401-461-0989
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH04411183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist