Provider Demographics
NPI:1063529600
Name:YAMMINE, KABALANE ASSAF (MD)
Entity type:Individual
Prefix:DR
First Name:KABALANE
Middle Name:ASSAF
Last Name:YAMMINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3 DEACON AVENUE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:SA
Mailing Address - Zip Code:5033
Mailing Address - Country:AU
Mailing Address - Phone:8-234-8311
Mailing Address - Fax:8-234-8355
Practice Address - Street 1:BEIT EL CHAAR, MARINA EL ACHKAR BUILDING, 3RD FLOOR
Practice Address - Street 2:
Practice Address - City:BEIRUT
Practice Address - State:--
Practice Address - Zip Code:75500
Practice Address - Country:LB
Practice Address - Phone:961-491-0098
Practice Address - Fax:961-491-0098
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01012324962085R0202X
PAMD0720841L2085R0202X
OH35-082445Y2085R0202X
NJ25MA075983002085R0202X
MI43010 832112085R0202X
CT0422982085R0202X
IN01058968A2085R0202X
MDD00629972085R0202X
IL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAH65517Medicare UPIN