Provider Demographics
NPI:1528582517
Name:SHAMMAA, YOUSSEF JAMAL (MD)
Entity Type:Individual
Prefix:MR
First Name:YOUSSEF
Middle Name:JAMAL
Last Name:SHAMMAA
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 1:475 SEAVIEW AVENUE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-2239
Mailing Address - Country:US
Mailing Address - Phone:718-226-8855
Mailing Address - Fax:718-226-1347
Practice Address - Street 1:475 SEAVIEW AVENUE
Practice Address - Street 2:
Practice Address - City:STATE ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-2239
Practice Address - Country:US
Practice Address - Phone:718-226-8855
Practice Address - Fax:718-226-1347
Is Sole Proprietor?:No
Enumeration Date:2017-08-01
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program