Provider Demographics
NPI:1114045077
Name:KAMARAH, YASSAH S (PBT)
Entity type:Individual
Prefix:
First Name:YASSAH
Middle Name:S
Last Name:KAMARAH
Suffix:
Gender:F
Credentials:PBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 GROTTO CT
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-1861
Mailing Address - Country:US
Mailing Address - Phone:301-523-2140
Mailing Address - Fax:301-515-7734
Practice Address - Street 1:9 GROTTO CT
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-1861
Practice Address - Country:US
Practice Address - Phone:301-523-2140
Practice Address - Fax:301-515-7734
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31066374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician