Provider Demographics
NPI:1609138700
Name:YOUSSEF, CHRISTIAN JOHN (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:JOHN
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 1:75A LAKE RD STE 155
Mailing Address - Street 2:
Mailing Address - City:CONGERS
Mailing Address - State:NY
Mailing Address - Zip Code:10920-2323
Mailing Address - Country:US
Mailing Address - Phone:845-589-0800
Mailing Address - Fax:
Practice Address - Street 1:4 MARTINE AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-4016
Practice Address - Country:US
Practice Address - Phone:347-962-5207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY290581-1208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation