Provider Demographics
NPI:1649462995
Name:FUTURE PEDIATRIC GROUP
Entity type:Organization
Organization Name:FUTURE PEDIATRIC GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FOUAD
Authorized Official - Middle Name:YOUNIS
Authorized Official - Last Name:RASHEED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-772-6999
Mailing Address - Street 1:PO BOX 8245
Mailing Address - Street 2:
Mailing Address - City:HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07538-0245
Mailing Address - Country:US
Mailing Address - Phone:973-772-6999
Mailing Address - Fax:973-772-6899
Practice Address - Street 1:240 N 8TH ST
Practice Address - Street 2:
Practice Address - City:PROSPECT PARK
Practice Address - State:NJ
Practice Address - Zip Code:07508-2002
Practice Address - Country:US
Practice Address - Phone:973-942-2131
Practice Address - Fax:973-942-6269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06164200208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6915809Medicaid