Basic Information
Provider Information
NPI: 1225419294
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ELKHASHAB
FirstName: YASMIN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 223 WILMINGTON W CHESTER PIKE STE 214
Address2:  
City: CHADDS FORD
State: PA
PostalCode: 193179007
CountryCode: US
TelephoneNumber: 8443657246
FaxNumber: 8445160080
Practice Location
Address1: 405 SILVERSIDE RD STE 104
Address2:  
City: WILMINGTON
State: DE
PostalCode: 198091768
CountryCode: US
TelephoneNumber: 8443657246
FaxNumber: 8445160080
Other Information
ProviderEnumerationDate: 06/15/2015
LastUpdateDate: 10/28/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/28/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XC1-0013773DEN Allopathic & Osteopathic PhysiciansAnesthesiology 
207LP2900XC1-0013773DEN Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
208VP0000XMD471080PAN Allopathic & Osteopathic PhysiciansPain MedicinePain Medicine
208VP0000XC1-0013773DEY Allopathic & Osteopathic PhysiciansPain MedicinePain Medicine

ID Information
IDTypeStateIssuerDescription
25059159505DE MEDICAID
40335886305PA MEDICAID


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