Provider Demographics
NPI:1801818711
Name:KAT, YOUSEF AZDIN
Entity Type:Individual
Prefix:DR
First Name:YOUSEF
Middle Name:AZDIN
Last Name:KAT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 HAMBURG TPKE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2162
Mailing Address - Country:US
Mailing Address - Phone:973-720-6655
Mailing Address - Fax:973-720-6644
Practice Address - Street 1:342 HAMBURG TPKE
Practice Address - Street 2:SUITE 105
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2162
Practice Address - Country:US
Practice Address - Phone:973-720-6655
Practice Address - Fax:973-720-6644
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0641652084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7388004Medicaid
NJMA064165OtherSTATE MEDICAL LICENSE
NJMA064165OtherSTATE MEDICAL LICENSE
NJMA064165OtherSTATE MEDICAL LICENSE
NJG56021Medicare UPIN