Provider Demographics
NPI:1215194352
Name:YOUNAN, NABIL YACOUB (MD)
Entity Type:Individual
Prefix:MR
First Name:NABIL
Middle Name:YACOUB
Last Name:YOUNAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CANDLEWOOD DRIVE
Mailing Address - Street 2:SEASHORE ANESTHESIA
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221
Mailing Address - Country:US
Mailing Address - Phone:609-927-7273
Mailing Address - Fax:609-927-7273
Practice Address - Street 1:2 CANDLEWOOD DRIVE
Practice Address - Street 2:SEASHORE ANESTHESIA
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221
Practice Address - Country:US
Practice Address - Phone:609-927-7273
Practice Address - Fax:609-927-7273
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA027653207LA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ780222355000OtherHORIZON BCBS
NJ3027309Medicaid
NJ3027309Medicaid