Individual provider Active NPI

Yahawah-Sha Mashiyach Yashar-Ahla, L.P.N.

  • Registered Nurse
  • Brooklyn, NY
National Provider Identifier
1063664100
Registry record updated Jul 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
646866 Issued in NY
Practice address
1055 E 83Rd St
Brooklyn, NY 11236-4225
Phone
(917) 348-7697
NPI assigned
Oct 21, 2008
Last updated
Jul 17, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 646866 NY Primary
Licensed Practical Nurse 164W00000X 269115 NY

Addresses

Primary practice location

1055 E 83Rd St
Brooklyn, NY 11236-4225

Mailing address

PO Box 210361
Brooklyn, NY 11221-0361
Phone (917) 348-7697

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
646866NYMDRegistered Nurse
269115NYMDMedical Oncology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1063664100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 210361",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112210361",
            "telephone_number": "917-348-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 E 83RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364225",
            "telephone_number": "917-348-7697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YASHAR-AHLA",
        "first_name": "YAHAWAH-SHA",
        "middle_name": "MASHIYACH",
        "credential": "L.P.N.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-21",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "646866",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "269115",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.