Provider Demographics
NPI:1780268540
Name:YOUSF, GERGES K (R PH)
Entity type:Individual
Prefix:
First Name:GERGES
Middle Name:K
Last Name:YOUSF
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 KENNEDY BLVD APT 2
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-3450
Mailing Address - Country:US
Mailing Address - Phone:201-388-3748
Mailing Address - Fax:201-420-8333
Practice Address - Street 1:222 JACKSON ST
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-6879
Practice Address - Country:US
Practice Address - Phone:201-420-8300
Practice Address - Fax:201-420-8333
Is Sole Proprietor?:No
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03484000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist