Provider Demographics
NPI:1578981064
Name:YUSUF, RAFI (DO)
Entity Type:Individual
Prefix:DR
First Name:RAFI
Middle Name:
Last Name:YUSUF
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 1:5707 146TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5350
Mailing Address - Country:US
Mailing Address - Phone:718-461-8625
Mailing Address - Fax:718-461-8628
Practice Address - Street 1:5707 146TH ST STE 1
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5350
Practice Address - Country:US
Practice Address - Phone:718-461-8625
Practice Address - Fax:718-461-8628
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292158207R00000X, 207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program