Provider Demographics
NPI:1750317418
Name:YOUSRY, AHMED S (MD)
Entity Type:Individual
Prefix:DR
First Name:AHMED
Middle Name:S
Last Name:YOUSRY
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 1:58 ROBIN GLEN RD
Mailing Address - Street 2:
Mailing Address - City:WATCHUNG
Mailing Address - State:NJ
Mailing Address - Zip Code:07069-6205
Mailing Address - Country:US
Mailing Address - Phone:908-822-7318
Mailing Address - Fax:
Practice Address - Street 1:377 JERSEY AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-4393
Practice Address - Country:US
Practice Address - Phone:201-763-6763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07533400207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0018074Medicaid
I00201Medicare UPIN