Provider Demographics
NPI:1942246194
Name:YOUNUS, MOHAMMAD W (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:W
Last Name:YOUNUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SULLIVAN WAY
Mailing Address - Street 2:TRENTON PSYCHIATRIC HOSPITAL
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08628
Mailing Address - Country:US
Mailing Address - Phone:609-633-1502
Mailing Address - Fax:609-587-4512
Practice Address - Street 1:SULLIVAN WAY
Practice Address - Street 2:TRENTON PSYCHIATRIC HOSPITAL
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08628
Practice Address - Country:US
Practice Address - Phone:609-633-1502
Practice Address - Fax:609-587-4512
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07533100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0049841Medicaid
NJ093270C2DOtherMEDICARE PROVIDER NUMBER
G40740Medicare UPIN
NJ0049841Medicaid