Provider Demographics
NPI:1902224488
Name:YASEEN, ALAE ABOD (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAE
Middle Name:ABOD
Last Name:YASEEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MSC PATHOLOGY DEPARTMENT 1 UNIVERSITY OF NEW MEXICO
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:502-852-8203
Mailing Address - Fax:
Practice Address - Street 1:MSC (PATHOLOGY) 1 UNIVERSITY OF NEW MEXICO
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-938-8456
Practice Address - Fax:505-938-8414
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA158460207ZP0102X
390200000X
NMRS2019-0563390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology