Provider Demographics
NPI:1689391112
Name:YASSIN, FIRAS A
Entity Type:Individual
Prefix:
First Name:FIRAS
Middle Name:A
Last Name:YASSIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 S DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-5903
Mailing Address - Country:US
Mailing Address - Phone:419-259-2000
Mailing Address - Fax:
Practice Address - Street 1:1200 S DETROIT AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-5903
Practice Address - Country:US
Practice Address - Phone:419-259-2000
Practice Address - Fax:419-213-7625
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH428151163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice