Healthcare Provider Details

I. General information

NPI: 1073830188
Provider Name (Legal Business Name): NESSIN H USSEIN PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2010
Last Update Date: 07/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2327 COTTMAN AVE
PHILADELPHIA PA
19149-1008
US

IV. Provider business mailing address

2327 COTTMAN AVE
PHILADELPHIA PA
19149-1008
US

V. Phone/Fax

Practice location:
  • Phone: 215-331-2858
  • Fax:
Mailing address:
  • Phone: 215-331-2858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP442377
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: