Provider Demographics
NPI:1700250891
Name:TABIBI, JASMINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:TABIBI
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 1:9939 62ND RD FL 2
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1474
Mailing Address - Country:US
Mailing Address - Phone:516-695-7223
Mailing Address - Fax:
Practice Address - Street 1:9939 62ND RD FL 2
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1474
Practice Address - Country:US
Practice Address - Phone:516-695-7223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-30
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061103183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist