Provider Demographics
NPI:1407677552
Name:AREIDA, YASMIN (MD, MS, CNS)
Entity type:Individual
Prefix:DR
First Name:YASMIN
Middle Name:
Last Name:AREIDA
Suffix:
Gender:F
Credentials:MD, MS, CNS
Other - Prefix:DR
Other - First Name:YASMIN
Other - Middle Name:
Other - Last Name:AREIDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, MS, CNS
Mailing Address - Street 1:1 GLENLOCH WAY
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355
Mailing Address - Country:US
Mailing Address - Phone:267-230-1072
Mailing Address - Fax:
Practice Address - Street 1:233 E LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-2321
Practice Address - Country:US
Practice Address - Phone:610-642-1330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA19020133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education