Provider Demographics
NPI:1922040666
Name:ABOU-ALLABAN, YOUSEF (MD)
Entity Type:Individual
Prefix:DR
First Name:YOUSEF
Middle Name:
Last Name:ABOU-ALLABAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:420 MAIN ST
Mailing Address - Street 2:SUITE 15
Mailing Address - City:WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02081-3753
Mailing Address - Country:US
Mailing Address - Phone:508-660-1666
Mailing Address - Fax:508-660-1667
Practice Address - Street 1:420 MAIN ST
Practice Address - Street 2:SUITE 15
Practice Address - City:WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02081-3753
Practice Address - Country:US
Practice Address - Phone:508-660-1666
Practice Address - Fax:508-660-1667
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA800512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3150674Medicaid
MA3150674Medicaid
MAA30790Medicare PIN