1679602908 NPI number — DR. MARGARET KATHLEEN YAVIL

Table of content: DR. YAMMA BROWN LUMAR PHARM.D. (NPI 1245623750)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679602908 NPI number — DR. MARGARET KATHLEEN YAVIL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YAVIL
Provider First Name:
MARGARET
Provider Middle Name:
KATHLEEN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
YAVIL
Provider Other First Name:
MARGARET
Provider Other Middle Name:
S.
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PSY.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1679602908
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/11/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
351 BAIRD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MERION STATION
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19066-1414
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-664-9958
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
630 FAIRVIEW RD
Provider Second Line Business Practice Location Address:
SUITE 207
Provider Business Practice Location Address City Name:
SWARTHMORE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19081-2334
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-544-9038
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  PS-006491-L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TS0200X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7811401 . This is a "AETNA PIN#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0773633000 . This is a "PERSONAL CHOICE PIN#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 200202 . This is a "COMPPSYCH ID#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 11633775 . This is a "AETNA RECREDENTIALING#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 554230 . This is a "VALUE OPTIONS PROVIDER#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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