Provider Demographics
NPI:1376754903
Name:YOUSSEF, HATIM (DO)
Entity Type:Individual
Prefix:
First Name:HATIM
Middle Name:
Last Name:YOUSSEF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2227 US HIGHWAY 1 # 277
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-4402
Mailing Address - Country:US
Mailing Address - Phone:732-737-7801
Mailing Address - Fax:
Practice Address - Street 1:3546 STATE ROUTE 27
Practice Address - Street 2:
Practice Address - City:KENDALL PARK
Practice Address - State:NJ
Practice Address - Zip Code:08824-1065
Practice Address - Country:US
Practice Address - Phone:732-737-7801
Practice Address - Fax:877-623-3456
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS020253207RC0200X
NJ25MB07711000207RP1001X, 207RC0200X
NJ25MBO7711000207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ121946XPFMedicare PIN