Provider Demographics
NPI:1922356237
Name:YASSIN, SULTAN SALEH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SULTAN
Middle Name:SALEH
Last Name:YASSIN
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 1:282 AVE JESUS T PINERO
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-3921
Mailing Address - Country:US
Mailing Address - Phone:787-523-2900
Mailing Address - Fax:787-777-1580
Practice Address - Street 1:282 AVE JESUS T PINERO
Practice Address - Street 2:SUITE 202
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-3921
Practice Address - Country:US
Practice Address - Phone:787-523-2900
Practice Address - Fax:787-777-1580
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5532183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5532OtherSTATE BOARD