Provider Demographics
NPI:1548221831
Name:GEORGY, YOUSSEF H (MD)
Entity Type:Individual
Prefix:
First Name:YOUSSEF
Middle Name:H
Last Name:GEORGY
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 1:30 BLACKSTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-5445
Mailing Address - Country:US
Mailing Address - Phone:401-467-0879
Mailing Address - Fax:401-467-0898
Practice Address - Street 1:30 BLACKSTONE BLVD
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-5445
Practice Address - Country:US
Practice Address - Phone:401-467-0879
Practice Address - Fax:401-467-0898
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD04069207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR000869OtherBLUE CHIP
RI28461OtherNEIGHBORHOOD HEALTH PLAN
RI216203OtherBLUE CROSS BLUE SHIELD
RI6828OtherHARVARD PILGIRM HEALTH CA
RI0400546OtherUNITEDHEALTH CARE
RIYF27420Medicaid
RI28461OtherNEIGHBORHOOD HEALTH PLAN