Provider Demographics
NPI:1326237702
Name:DOC MEDICAL PRACTICE OF YONKERS
Entity Type:Organization
Organization Name:DOC MEDICAL PRACTICE OF YONKERS
Other - Org Name:NONE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:FAMILY PRACTICE
Authorized Official - Prefix:DR
Authorized Official - First Name:HANNI
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:YOUSSEF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-779-2995
Mailing Address - Street 1:DOC
Mailing Address - Street 2:116 FIFTH AVENUE
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-1504
Mailing Address - Country:US
Mailing Address - Phone:914-779-2995
Mailing Address - Fax:914-779-3507
Practice Address - Street 1:DOC
Practice Address - Street 2:116 FIFTH AVENUE
Practice Address - City:PELHAM
Practice Address - State:NY
Practice Address - Zip Code:10803-1504
Practice Address - Country:US
Practice Address - Phone:914-779-2995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY245754173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty