Provider Demographics
NPI:1851057194
Name:YOUSSEF, TAREK OMAR (DVM)
Entity Type:Individual
Prefix:DR
First Name:TAREK
Middle Name:OMAR
Last Name:YOUSSEF
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 E 72ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4414
Mailing Address - Country:US
Mailing Address - Phone:917-675-6270
Mailing Address - Fax:
Practice Address - Street 1:417 E 72ND ST APT 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4415
Practice Address - Country:US
Practice Address - Phone:917-675-6270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013636-1208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty