Provider Demographics
NPI:1689694903
Name:ZACHARY, YOUSSEF ISKANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:YOUSSEF
Middle Name:ISKANDER
Last Name:ZACHARY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:YOUSSEF
Other - Middle Name:ISKANDER
Other - Last Name:ZACHARY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:686 MANOR RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-4525
Mailing Address - Country:US
Mailing Address - Phone:718-494-7051
Mailing Address - Fax:
Practice Address - Street 1:686 MANOR RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-4525
Practice Address - Country:US
Practice Address - Phone:718-494-7051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210195207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01879125Medicaid