Provider Demographics
NPI:1033833439
Name:YASSINE, HIKMAT (PHARMD)
Entity Type:Individual
Prefix:
First Name:HIKMAT
Middle Name:
Last Name:YASSINE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6216 ORCHARD AVE
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2005
Mailing Address - Country:US
Mailing Address - Phone:313-247-0061
Mailing Address - Fax:
Practice Address - Street 1:3090 CARPENTER RD # 48197
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-9611
Practice Address - Country:US
Practice Address - Phone:734-973-7402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-28
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302414629333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy