Provider Demographics
NPI:1689120818
Name:ELHEFNAWY, YASMINE H (MD)
Entity Type:Individual
Prefix:
First Name:YASMINE
Middle Name:H
Last Name:ELHEFNAWY
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:BMC PROVIDER ENROLLMENT OFFICE
Mailing Address - Street 2:960 MASSACHUSETTS AVE,.2ND FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-414-5405
Mailing Address - Fax:
Practice Address - Street 1:725 ALBANY STREET
Practice Address - Street 2:SHAPIRO BLDG., STE 8C
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-414-4841
Practice Address - Fax:617-414-4502
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2024-04-05
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Provider Licenses
StateLicense IDTaxonomies
MA294360208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics