Provider Demographics
NPI:1255519211
Name:YASIN, AFZAL
Entity type:Individual
Prefix:MR
First Name:AFZAL
Middle Name:
Last Name:YASIN
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 1:389 E 138TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10454-3099
Mailing Address - Country:US
Mailing Address - Phone:718-742-0001
Mailing Address - Fax:718-742-0011
Practice Address - Street 1:389 E 138TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-3099
Practice Address - Country:US
Practice Address - Phone:718-742-0001
Practice Address - Fax:718-742-0011
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045050183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist