Provider Demographics
NPI:1871196691
Name:XU, YIMIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:YIMIN
Middle Name:
Last Name:XU
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 1:225 ELMLAWN RD
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-1504
Mailing Address - Country:US
Mailing Address - Phone:908-930-9287
Mailing Address - Fax:
Practice Address - Street 1:1145 KEMPTON ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-1531
Practice Address - Country:US
Practice Address - Phone:508-999-3241
Practice Address - Fax:508-996-5440
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4019183500000X
MAPH235562183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist