Provider Demographics
NPI:1871647297
Name:YOUSSEF, RULA (MD)
Entity Type:Individual
Prefix:
First Name:RULA
Middle Name:
Last Name:YOUSSEF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 MERRIMACK ST.
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843
Mailing Address - Country:US
Mailing Address - Phone:978-685-2455
Mailing Address - Fax:978-685-2459
Practice Address - Street 1:280 MERRIMACK ST.
Practice Address - Street 2:SUITE 103
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843
Practice Address - Country:US
Practice Address - Phone:978-685-2455
Practice Address - Fax:978-685-2459
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA222377207Q00000X
MA234690207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000942801Medicare PIN