Provider Demographics
NPI:1831814227
Name:YASIN, FATHIMATHUZ ZOHRA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:FATHIMATHUZ
Middle Name:ZOHRA
Last Name:YASIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 EMERALD TRL
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14221-8333
Mailing Address - Country:US
Mailing Address - Phone:716-796-5448
Mailing Address - Fax:
Practice Address - Street 1:1105 BROADWAY ST STE 8
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14212-1553
Practice Address - Country:US
Practice Address - Phone:716-424-2433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-07
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069193183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist