Basic Information
Provider Information
NPI: 1649385188
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YASEEN
FirstName: NABEEL
MiddleName: R
NamePrefix: DR.
NameSuffix:  
Credential: MD PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 660 S EUCLID AVE
Address2: C B 8118
City: SAINT LOUIS
State: MO
PostalCode: 631101010
CountryCode: US
TelephoneNumber: 3143625641
FaxNumber: 3143620369
Practice Location
Address1: 216 S KINGSHIGHWAY BLVD
Address2:  
City: SAINT LOUIS
State: MO
PostalCode: 631101026
CountryCode: US
TelephoneNumber: 3143625641
FaxNumber: 3143620369
Other Information
ProviderEnumerationDate: 08/21/2006
LastUpdateDate: 02/04/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZH0000X2007028772MON Allopathic & Osteopathic PhysiciansPathologyHematology
207ZP0102X2007028772MOY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

No ID Information.


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