Provider Demographics
NPI:1376515338
Name:YOUKELES, LISA HOPE (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:HOPE
Last Name:YOUKELES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 HUGUENOT ST
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-7760
Mailing Address - Country:US
Mailing Address - Phone:914-607-5820
Mailing Address - Fax:914-607-5821
Practice Address - Street 1:171 HUGUENOT ST
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-7760
Practice Address - Country:US
Practice Address - Phone:914-607-5820
Practice Address - Fax:914-607-5821
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1670821207R00000X, 207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01291923Medicaid
NY01291923Medicaid
NY78F341Medicare ID - Type Unspecified