Provider Demographics
NPI:1639770480
Name:YUSSUF, BABATOLA O (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BABATOLA
Middle Name:O
Last Name:YUSSUF
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 LOUISBURG SQ APT 5
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-5532
Mailing Address - Country:US
Mailing Address - Phone:781-799-8012
Mailing Address - Fax:
Practice Address - Street 1:254 LOWELL RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051-4913
Practice Address - Country:US
Practice Address - Phone:603-598-4638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHPHCY-04530183500000X
MAPH239249183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist