Provider Demographics
NPI:1730478363
Name:BENNANI, YUSSEF (MD)
Entity Type:Individual
Prefix:
First Name:YUSSEF
Middle Name:
Last Name:BENNANI
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 1:1542 TULANE AVE
Mailing Address - Street 2:SUITE 331
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2865
Mailing Address - Country:US
Mailing Address - Phone:504-568-5031
Mailing Address - Fax:504-568-5553
Practice Address - Street 1:1542 TULANE AVE
Practice Address - Street 2:SUITE 331
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2865
Practice Address - Country:US
Practice Address - Phone:504-568-5031
Practice Address - Fax:504-568-5553
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.206918207RI0200X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease