Provider Demographics
NPI:1841068087
Name:YU DE JESUS, CRYSTAL L (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:L
Last Name:YU DE JESUS
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB REPARTO VALENCIA C/ TULIPAN 2
Mailing Address - Street 2:J8F APT A
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-908-9560
Mailing Address - Fax:
Practice Address - Street 1:282 AVE JESUS T PINERO STE 208
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-3917
Practice Address - Country:US
Practice Address - Phone:787-523-3888
Practice Address - Fax:888-855-8865
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8185183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist