Provider Demographics
NPI:1891715397
Name:YOUSEF, MONA (DPM)
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:YOUSEF
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2399 HIGHWAY 34 BLDG A6
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1500
Mailing Address - Country:US
Mailing Address - Phone:732-528-8223
Mailing Address - Fax:
Practice Address - Street 1:2399 HIGHWAY 34 BLDG A6
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1500
Practice Address - Country:US
Practice Address - Phone:732-528-8223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD2038213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1154506400OtherGROUP NPI
NJ708336XYWOtherGROUP MEDICARE PIN
NJ708336XYWOtherGROUP MEDICARE PIN
NJ1154506400OtherGROUP NPI
NJ708336Medicare PIN