Provider Demographics
NPI:1225290968
Name:YOSEF J. MORAD, M.D. P.C.
Entity Type:Organization
Organization Name:YOSEF J. MORAD, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:YOSEF
Authorized Official - Middle Name:J
Authorized Official - Last Name:MORAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-575-2900
Mailing Address - Street 1:6854 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367
Mailing Address - Country:US
Mailing Address - Phone:718-575-2900
Mailing Address - Fax:718-575-2194
Practice Address - Street 1:6854 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1325
Practice Address - Country:US
Practice Address - Phone:718-575-2900
Practice Address - Fax:718-575-2194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY175343261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01175951Medicaid