Provider Demographics
NPI:1881002814
Name:YOUSSEFI, ABTIN (PHARM D)
Entity Type:Individual
Prefix:
First Name:ABTIN
Middle Name:
Last Name:YOUSSEFI
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12800 MIDDLEBROOK RD # 112-A
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-5204
Mailing Address - Country:US
Mailing Address - Phone:301-569-6907
Mailing Address - Fax:301-569-4196
Practice Address - Street 1:12800 MIDDLEBROOK RD # 112-A
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-5204
Practice Address - Country:US
Practice Address - Phone:301-569-6907
Practice Address - Fax:301-569-4196
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15309183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist