Provider Demographics
NPI:1073993671
Name:YOUSEF, AYMAN
Entity Type:Individual
Prefix:
First Name:AYMAN
Middle Name:
Last Name:YOUSEF
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 1:28511 DUPONT BLVD
Mailing Address - Street 2:
Mailing Address - City:MILLSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19966-4787
Mailing Address - Country:US
Mailing Address - Phone:302-934-8175
Mailing Address - Fax:
Practice Address - Street 1:28511 DUPONT BLVD
Practice Address - Street 2:
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966-4787
Practice Address - Country:US
Practice Address - Phone:302-934-8175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-09
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0004735183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist