Provider Demographics
NPI:1518597228
Name:RHAFFOR, YASSINE
Entity type:Individual
Prefix:
First Name:YASSINE
Middle Name:
Last Name:RHAFFOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 E 79TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0819
Mailing Address - Country:US
Mailing Address - Phone:718-844-3178
Mailing Address - Fax:
Practice Address - Street 1:211 E 79TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0819
Practice Address - Country:US
Practice Address - Phone:718-844-3178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334721164W00000X
372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
No164W00000XNursing Service ProvidersLicensed Practical Nurse