Provider Demographics
NPI:1962439620
Name:YOUSEF, TARIQ ANWAR (MD)
Entity Type:Individual
Prefix:DR
First Name:TARIQ
Middle Name:ANWAR
Last Name:YOUSEF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:67 WILLOW DR
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1227
Mailing Address - Country:US
Mailing Address - Phone:914-462-9072
Mailing Address - Fax:
Practice Address - Street 1:67 WILLOW DR
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-1227
Practice Address - Country:US
Practice Address - Phone:914-462-9072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2363302084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY168098Medicare PIN