Provider Demographics
NPI:1932818440
Name:NOOR AHMAD, YASAMIN
Entity Type:Individual
Prefix:
First Name:YASAMIN
Middle Name:
Last Name:NOOR AHMAD
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 1:24951 BIG BELT CT
Mailing Address - Street 2:
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105-5606
Mailing Address - Country:US
Mailing Address - Phone:571-201-5504
Mailing Address - Fax:
Practice Address - Street 1:14391 CHANTILLY CROSSING LN
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-2118
Practice Address - Country:US
Practice Address - Phone:571-262-0021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202220940183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist