Provider Demographics
NPI:1346042496
Name:YAICHE, MOHANED
Entity type:Individual
Prefix:
First Name:MOHANED
Middle Name:
Last Name:YAICHE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 S MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-4035
Mailing Address - Country:US
Mailing Address - Phone:614-254-8935
Mailing Address - Fax:
Practice Address - Street 1:1018 S MULBERRY ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-4035
Practice Address - Country:US
Practice Address - Phone:614-254-8935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care