Provider Demographics
NPI:1073654240
Name:YASSIN, ABDULLAH A
Entity type:Individual
Prefix:
First Name:ABDULLAH
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:E10 CALLE 9
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-4038
Mailing Address - Country:US
Mailing Address - Phone:787-784-5265
Mailing Address - Fax:787-784-0900
Practice Address - Street 1:CALLE 9 E-10
Practice Address - Street 2:
Practice Address - City:DOS RIOS-VALPARAISO
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-795-4181
Practice Address - Fax:787-753-7108
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3819183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist