Provider Demographics
NPI:1326065079
Name:MASIH, YOUNUS F (MD)
Entity Type:Individual
Prefix:DR
First Name:YOUNUS
Middle Name:F
Last Name:MASIH
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 1:15 PALOMBA DRIVE
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082
Mailing Address - Country:US
Mailing Address - Phone:860-745-0204
Mailing Address - Fax:860-741-8944
Practice Address - Street 1:15 PALOMBA DRIVE
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082
Practice Address - Country:US
Practice Address - Phone:860-745-0204
Practice Address - Fax:860-741-8944
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT019095207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1190958Medicaid
CT290000044Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CTB84611Medicare UPIN