Provider Demographics
NPI:1669795605
Name:YOUSSEF, ADNAN M (RPH)
Entity type:Individual
Prefix:MR
First Name:ADNAN
Middle Name:M
Last Name:YOUSSEF
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:ADNAN
Other - Middle Name:M
Other - Last Name:YOUSSEF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BSC PHARM
Mailing Address - Street 1:680 DRUMGOOLE RD W
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-1968
Mailing Address - Country:US
Mailing Address - Phone:718-966-4158
Mailing Address - Fax:
Practice Address - Street 1:680 DRUMGOOLE RD W
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-1968
Practice Address - Country:US
Practice Address - Phone:718-966-4158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029380183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist