Provider Demographics
NPI:1699413948
Name:ARAFY, YOSR
Entity Type:Individual
Prefix:
First Name:YOSR
Middle Name:
Last Name:ARAFY
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 1:10 SUMMER ST APT 403
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-3927
Mailing Address - Country:US
Mailing Address - Phone:954-708-9183
Mailing Address - Fax:
Practice Address - Street 1:339 SQUIRE RD STE 150
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-4396
Practice Address - Country:US
Practice Address - Phone:781-286-7510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN26946122300000X
390200000X
MADN1859425122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program