Provider Demographics
NPI:1922374248
Name:ABDUR-RASHEED, YASIN ALI (LPN)
Entity Type:Individual
Prefix:
First Name:YASIN ALI
Middle Name:
Last Name:ABDUR-RASHEED
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 1ST ST
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-3701
Mailing Address - Country:US
Mailing Address - Phone:631-575-7054
Mailing Address - Fax:631-946-6575
Practice Address - Street 1:2 1ST ST
Practice Address - Street 2:
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-3701
Practice Address - Country:US
Practice Address - Phone:631-575-7054
Practice Address - Fax:631-946-6575
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307686164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse