Provider Demographics
NPI:1902198930
Name:ENDRAWS, YOUSSEF MOUSA
Entity Type:Individual
Prefix:
First Name:YOUSSEF
Middle Name:MOUSA
Last Name:ENDRAWS
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 1:8727 26TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-5406
Mailing Address - Country:US
Mailing Address - Phone:347-296-7257
Mailing Address - Fax:
Practice Address - Street 1:1122 CONEY ISLAND AVE
Practice Address - Street 2:#205
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-2345
Practice Address - Country:US
Practice Address - Phone:718-975-1119
Practice Address - Fax:718-975-1120
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032919225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist