Provider Demographics
NPI:1477370732
Name:YOUSSEF, SOMAR HANNA
Entity type:Individual
Prefix:
First Name:SOMAR
Middle Name:HANNA
Last Name:YOUSSEF
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 1:3768 FAIRWAY PARK DR APT 107
Mailing Address - Street 2:
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-2988
Mailing Address - Country:US
Mailing Address - Phone:330-389-0587
Mailing Address - Fax:
Practice Address - Street 1:3768 FAIRWAY PARK DR APT 107
Practice Address - Street 2:
Practice Address - City:COPLEY
Practice Address - State:OH
Practice Address - Zip Code:44321-2988
Practice Address - Country:US
Practice Address - Phone:330-389-0587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant